Background Pancreatic duct leakage is often caused by pancreatic injury caused by acute and chronic pancreatitis and trauma. The common treatment options include: conservative treatment, surgical treatment, percutaneous drainage and endoscopic treatment. ERCP technology provides a new solution for the drainage treatment of pancreatic duct leakage. Still, in some patients with pancreatic duct stenosis, difficult pancreatic duct intubation, surgery and other factors, ERCP does not fully cover the cases of pancreatic duct leakage. The success of the operation is highly correlated with the surgeon’s experience and other factors. In the case of ERCP pancreatic tube intubation failure, endoscopic ultrasonography-guided pancreatic duct drainage (EUS-PD) is the new remedy. Common procedures of EUS-PD include EUS-guided rendezvous (EUS-RV) and EUS-guided transmural drainage (EUS-TMD), connecting the pancreatic duct through the nipple or puncture channel.

Methods On this basis, based on EUS-TMD in our center, the puncture site was expanded from the pancreatic duct to the fistula for drainage treatment. We reviewed 10 patients with pancreatic leakage at our center from October 2022 to April 2024.

Results This included 6 patients with an ERCP and 4 fistula drainage (one of them followed by a pancreatic duct drainage). (Median age 54 years, interquartile spacing [IQR] 14; male 80% [n=8]), no adverse events. There is no obvious difference between the drainage effect and the nipple catheterization drainage effect.

Conclusions It proves that the operation of transsinus drainage for pancreatic duct leakage can be effective in treating pancreatic duct leakage and increase the chance of success of the surgery.