Advanced Endoscopy Fellows Program | September 2024-EUS-Guided Rendezvous Case

Video Transcription

Video Summary

Dr. Richard Kwon from the University of Michigan discusses the complexity of endoscopic ultrasound (EUS)-guided pancreatic drainage in a 52-year-old woman with a history of recurrent pancreatitis following a Whipple procedure 15 years ago. Despite elevated lipase levels and persistent duct dilation, traditional endoscopic methods failed to access the pancreatic duct, leading to the consideration of EUS-guided intervention. The procedure involves identifying the pancreatic duct via fluoroscopy, guide wire manipulation, and possible stent placement. While technically challenging, with a steep learning curve, it can offer relief when other methods fail. However, its adverse event rate is notable, with complications like pancreatitis and peritonitis. Despite initial success, the patient’s symptoms recurred, prompting discussions on alternative interventions, such as using secretin stimulation or heated device insertion. The case emphasizes the difficulty in performing such advanced procedures and the need for continued innovations in addressing complex pancreatic disorders.

Asset Subtitle

Dr. Rich Kwon

Keywords

endoscopic ultrasound

pancreatic drainage

Whipple procedure

EUS-guided intervention

pancreatic disorders

complications