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Outcomes of minor versus major papilla rendez-vous for EUS-guided pancreatic duct drainage

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Title: Outcomes of minor versus major papilla rendez-vous for EUS-guided pancreatic duct drainage
Authors: Bronswijk, Michiel, Persyn, Diederik, van Malenstein, Hannah, Laleman, Wim, van der Merwe, Schalk
Source: ISSN:1590-8658 ; ISSN:1878-3562 ; Digestive And Liver Disease, vol. 56 (1), (170-175.
Publisher Information: Elsevier
Publication Year: 2024
Subject Terms: Science & Technology, Life Sciences & Biomedicine, Gastroenterology & Hepatology, EUS-guided pancreatogastrostomy, Chronic pancreatitis, Main pancreatic duct stones, Endoscopic retrograde pancreatography, FAILED ERCP, Female, Humans, Male, Middle Aged, Ampulla of Vater, Cholangiopancreatography, Endoscopic Retrograde, Drainage, Endosonography, Pancreatic Ducts, Pancreatitis, Chronic, Retrospective Studies, Treatment Outcome, Aged, 1103 Clinical Sciences, 3202 Clinical sciences
Description: OBJECTIVES: EUS-guided pancreatic duct drainage (EUS-PD) using rendez-vous has been suggested as a safer alternative to pancreatogastrostomy. Fibrostenotic disease in the pancreatic head may however preclude major papilla rendez-vous, leading to preferential guidewire advancement through the minor papilla. Our aim was to compare the outcomes of minor and major papilla rendez-vous. METHODS: This is a tertiary single-center retrospective analysis of all consecutive EUS-PD procedures performed from 2015 to April 2022. EUS-PD was only performed following failed retrograde attempts. Successful EUS-PD rendez-vous cases were included and minor and major papilla procedures were compared. RESULTS: Thirty-three patients were included in the final analysis (66.6% male, mean age 56.1 [SD±14.8] years, 54.6% active smokers). In 21 patients (63.6%), minor papilla rendez-vous was attained. Clinical success was achieved in 81.0% vs. 58.3% in the major papilla group (p = 0.230). The overall incidence of AE was similar in both groups (9 [42.9%] vs. 4 [33.3%] events, p = 0.719), with a comparable distribution in severe, moderate and mild AE. Incidence of recurrent pancreatitis was almost identical (28.6% vs. 25.0%, p = 1.000). CONCLUSIONS: For patients with symptomatic chronic pancreatitis, EUS-PD using minor or major papilla rendez-vous attained similar results, suggesting that pancreatic duct drainage through the minor papilla can be considered as equally effective. ; status: Published
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://lirias.kuleuven.be/handle/20.500.12942/724167; https://doi.org/10.1016/j.dld.2023.07.027; https://pubmed.ncbi.nlm.nih.gov/37558573
DOI: 10.1016/j.dld.2023.07.027
Availability: https://lirias.kuleuven.be/handle/20.500.12942/724167
https://hdl.handle.net/20.500.12942/724167
https://lirias.kuleuven.be/retrieve/2d8862ca-4907-437d-9adf-e3a33be2a8f2
https://doi.org/10.1016/j.dld.2023.07.027
https://pubmed.ncbi.nlm.nih.gov/37558573
Rights: info:eu-repo/semantics/openAccess ; public ; All rights reserved
Accession Number: edsbas.233F7601
Database: BASE
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  Data: Outcomes of minor versus major papilla rendez-vous for EUS-guided pancreatic duct drainage
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  Data: <searchLink fieldCode="AR" term="%22Bronswijk%2C+Michiel%22">Bronswijk, Michiel</searchLink><br /><searchLink fieldCode="AR" term="%22Persyn%2C+Diederik%22">Persyn, Diederik</searchLink><br /><searchLink fieldCode="AR" term="%22van+Malenstein%2C+Hannah%22">van Malenstein, Hannah</searchLink><br /><searchLink fieldCode="AR" term="%22Laleman%2C+Wim%22">Laleman, Wim</searchLink><br /><searchLink fieldCode="AR" term="%22van+der+Merwe%2C+Schalk%22">van der Merwe, Schalk</searchLink>
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  Data: <i>ISSN:1590-8658 ; ISSN:1878-3562 ; Digestive And Liver Disease, vol. 56 (1), (170-175</i>.
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  Data: 2024
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  Data: OBJECTIVES: EUS-guided pancreatic duct drainage (EUS-PD) using rendez-vous has been suggested as a safer alternative to pancreatogastrostomy. Fibrostenotic disease in the pancreatic head may however preclude major papilla rendez-vous, leading to preferential guidewire advancement through the minor papilla. Our aim was to compare the outcomes of minor and major papilla rendez-vous. METHODS: This is a tertiary single-center retrospective analysis of all consecutive EUS-PD procedures performed from 2015 to April 2022. EUS-PD was only performed following failed retrograde attempts. Successful EUS-PD rendez-vous cases were included and minor and major papilla procedures were compared. RESULTS: Thirty-three patients were included in the final analysis (66.6% male, mean age 56.1 [SD±14.8] years, 54.6% active smokers). In 21 patients (63.6%), minor papilla rendez-vous was attained. Clinical success was achieved in 81.0% vs. 58.3% in the major papilla group (p = 0.230). The overall incidence of AE was similar in both groups (9 [42.9%] vs. 4 [33.3%] events, p = 0.719), with a comparable distribution in severe, moderate and mild AE. Incidence of recurrent pancreatitis was almost identical (28.6% vs. 25.0%, p = 1.000). CONCLUSIONS: For patients with symptomatic chronic pancreatitis, EUS-PD using minor or major papilla rendez-vous attained similar results, suggesting that pancreatic duct drainage through the minor papilla can be considered as equally effective. ; status: Published
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  Data: https://lirias.kuleuven.be/handle/20.500.12942/724167; https://doi.org/10.1016/j.dld.2023.07.027; https://pubmed.ncbi.nlm.nih.gov/37558573
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  Data: https://lirias.kuleuven.be/handle/20.500.12942/724167<br />https://hdl.handle.net/20.500.12942/724167<br />https://lirias.kuleuven.be/retrieve/2d8862ca-4907-437d-9adf-e3a33be2a8f2<br />https://doi.org/10.1016/j.dld.2023.07.027<br />https://pubmed.ncbi.nlm.nih.gov/37558573
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        Value: 10.1016/j.dld.2023.07.027
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      – Text: English
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        Type: general
      – SubjectFull: Life Sciences & Biomedicine
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