ASGE DDW Videos from Around the World | 2026-ENDOSCOPIC ULTRASOUND-GUIDED INTERNALIZATION OF A MORE THAN ONE-YEAR-OLD CHRONIC PANCREATICO-CUTANEOUS FISTULA USING A BALLOON-TARGET TECHNIQUE

ENDOSCOPIC ULTRASOUND-GUIDED INTERNALIZATION OF A MORE THAN ONE-YEAR-OLD CHRONIC PANCREATICO-CUTANEOUS FISTULA USING A BALLOON-TARGET TECHNIQUE

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Video Transcription

Video Summary

A 36-year-old man developed a chronic high-output pancreatic cutaneous fistula after percutaneous drainage for necrotizing pancreatitis and disconnected pancreatic duct syndrome. Because surgery is morbid and ERCP was not feasible, the team used EUS-guided internalization. A balloon target placed through the existing percutaneous tract created a safe sonographic target in the collapsed cavity, allowing transgastric puncture, guidewire passage, tract dilation, and placement of a double-pigtail stent. The external tract was also de-epithelialized by IR. Drainage stopped within days, the fistula healed completely, and the patient remained well at 2 months.

Asset Subtitle

H. Kim, I. Hassan, A. Wallace, N. Fukami,

Keywords

disconnected pancreatic duct syndrome

EUS-guided internalization

pancreatic cutaneous fistula

necrotizing pancreatitis

double-pigtail stent