An 83-year-old man was admitted to our department, presenting with jaundice, fever, and nausea. CT revealed a pancreatic head tumor with duodenal invasion. Endoscopic transpapillary biliary drainage was unsuccessful due to stenosis at the second portion of the duodenum and tumor invasion to the papilla of Vater. Using a convex linear array echoendoscope, a fully-covered metal stent was placed a...

Precut papillotomy (PP) is a useful technique for overcoming a difficult biliary cannulation (DBC). Various techniques and devices have been introduced for successful PP. PP using needle-knife (NK) is the main modalities, and PP using pull-type papillotome, transpancreatic septotomy (TPS), was firstly introduced by Goff in 1995. After then TPS with or without guidewire or/and pancreatic stent w...

BACKGROUND Preoperative biliary drainage (PBD) has been widely used to treat patients with malignant biliary obstruction. However, it is still unclear which method of PBD (endoscopic nasobiliary drainage or endoscopic biliary stenting) is more effective. Thus, we carried out a meta-analysis to compare the safety and efficacy of endoscopic nasobiliary drainage (ENBD) and endoscopic biliary stent...

A previously well, 73-year-old woman presented with chest pain and was noted to have markedly abnormal cholestatic liver function tests. Magnetic resonance cholangiopancreatography (MRCP) demonstrated a multicystic mass in the pancreatic head with possible extrinsic biliary compression. She underwent endoscopic ultrasound (EUS) with cytological aspiration, which demonstrated dysplastic cellular...

The patient was a 58-year-old man with a long-standing history of alcohol abuse and chronic pancreatitis leading to multiple hospitalizations. He continued to have pain despite conservative management, pain control, and alcohol cessation. His chronic pancreatitis and pancreatic duct (PD) stones resulted in a tight PD stricture at the head of the pancreas. Multiple prior attempts at conventional...

A novel lumen-apposing self-expandable metal stent (LAMS; Axios EC; Boston Scientific Corp., Marlborough, Massachusetts, USA) that is able to create a stable communicating fistulous tract has simplified the performance of endoscopic necrosectomy for walled-off pancreatic necrosis (WOPN). A 44-year-old man with a 10-cm WOPN (>50% solid component) underwent successful endoscopic ultrasound (EUS)g...

Medical treatment of chronic pancreatitis is based on the three main characteristics of the disease, pain and exocrine and endocrine insufficiency. Pain is the leading symptom of chronic pancreatitis. Patients may suffer from continuous pain or relapsing pain in parallel with relapses of the chronic inflammatory process or complications. Pain may decrease over time due to what is called “burn o...

AIM To evaluate the use of fully covered self-expandable metal stents (FCSEMSs) for pancreatic duct strictures in children with chronic pancreatitis. METHODS Eight patients with refractory benign dominant stricture of the main pancreatic duct (MPD) were enrolled through chart reviews between December 2014 and June 2017 in a single center. Endoscopic retrograde cholangiopancreatography (ERCP) ...