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Stricture at Pancreatico-Jejunostomy or Pancreatico-Gastrostomy

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Gastrointestinal Surgery

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Abstract

Stricture at the pancreatojejunostomy or pancreatogastrostomy after pancreatoduodenectomy is fairly common. It frequently contributes to pancreatic exocrine insufficiency and sometimes is associated with the debilitating attacks of pancreatic pain and pancreatitis. Diagnosis is best achieved by secretin-stimulated magnetic resonance (MR) pancreatography. Surgical reconstruction has been used for recurrent severe pain but the procedure is difficult and results are mixed. Endoscopic treatments of pancreatico-jejunostomy anastomotic (PJA) strictures have advanced rapidly in the recent past and are now the first-line therapy. Direct puncture of the pancreatic duct through the stomach using endoscopic ultrasound (EUS) has revolutionized endoscopic treatment and permitted several new endoscopic treatments of PJA strictures.

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Author information

Authors and Affiliations

  1. Department of Surgery, Barnes-Jewish Hospital, Washington University in St. Louis, St. Louis, MO, USA

    Prof. Steven M. Strasberg MD

  2. Department of Internal Medicine, Division of Gastroenterology, Washington University in St. Louis, St. Louis, MO, USA

    Assoc. Prof. Daniel K. Mullady MD

Authors
  1. Prof. Steven M. Strasberg MD
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  2. Assoc. Prof. Daniel K. Mullady MD
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Corresponding author

Correspondence to Steven M. Strasberg MD .

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, Johns Hopkins Hospital, Baltimore, Maryland, USA

    Timothy M. Pawlik

  2. Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA

    Shishir K. Maithel

  3. Professor of Surgery, Division of Surgical Oncology, University of Miami, Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, Florida, USA

    Nipun B. Merchant

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Strasberg, S., Mullady, D. (2015). Stricture at Pancreatico-Jejunostomy or Pancreatico-Gastrostomy. In: Pawlik, T., Maithel, S., Merchant, N. (eds) Gastrointestinal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2223-9_24

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  • DOI: https://doi.org/10.1007/978-1-4939-2223-9_24

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2222-2

  • Online ISBN: 978-1-4939-2223-9

  • eBook Packages: MedicineMedicine (R0)

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