Publication

Abstract : Pancreatic Duct (PD) leak leading to pancreatic ascites is a serious complication of chronic pancreatitis. Endoscopic management has been found to be feasible and safe in these patients and includes Endoscopic Retrograde Cholangio Pancreaticography (ERCP) with selective cannulation of the pancreatic duct and trans-papillary drainage by a pancreatic sphincterotomy followed by stent placement ideally bridging the location of the leak. Endoscopic ultrasound (EUS) guided rendezvous procedures are a promising alternative in patients who have a failed ERCP. A dilated Pancreatic duct(PD) is ideal for a successful EUS guided rendezvous procedure. Till date, EUS guided rendezvous procedures have not been reported for patients with pancreatic ascites. We report a modified EUS guided rendezvous technique which was successfully performed to treat a patient with pancreatic ascites especially in the setting of a non-dilated PD. In this patient, ERCP was unsuccessful and he was a high risk surgical candidate.