P1378 Endoscopic ultrasound guided methylene blue injection: An innovative endoscopic approach to a post-ampullectomy papillary stenosis and recurrent pancreatitis

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Ampullary adenomas (AA) are common in patients with familial adenomatous polyposis (FAP). Endoscopic resection is recommended for large AA, but has been associated with high rates of iatrogenic pancreatitis. Prophylactic pancreatic duct (PD) stenting is recommended in patients undergoing ampullectomy. A case is presented describing an innovative technique of PD stenting, in a patient with FAP post ampullectomy, using endoscopic ultrasound (EUS) guided methylene blue injection, to assist in PD identification, cannulation, and successful stent deployment after failed standard endoscopic retrograde cholangiopancreatography (ERCP).


American College of Gastroenterology Annual Meeting, Orlando, FL, October 13-18, 2017. Awarded: 2017 Presidential Poster.