, et clinique étaient respectivement de 92,5% / 87

/. 23%,

. Plus-récemment and . Oh, 35) ont rapporté l'utilisation d'un stent métallique pancréatique lors de la réalisation d'une WG-EUS (stent métallique auto-expansible entièrement recouvert [FCSEMS]). Les taux de succès technique et clinique étaient de 100% chez 25 patients atteints de dilatation symptomatique du canal principal avec échec de CPRE préalable

. Le, Une étude récente propose la voie trans-bulbaire en première intention avec comme argument principal, une stabilité de l'endoscope supérieur au sein du bulbe (36)

, De nombreuses questions demeurent aussi quant à l'utilisation d'un schéma standardisé concernant l'intervalle entre les changements et la durée nécessaire pour obtenir une calibration

É. Dans-notre, Nous proposons un algorithme de prise en charge préconisant un changement de prothèse tous les 6 mois pendant 24 mois, puis une tentative de retrait (figure 4). D'autre part le fait que l'anastomose wirsungogastrique peut persister dans le temps en l'absence de stent par un phénomène de fibrose paraît intéressant. Dans notre étude, nous avons pu observer chez 5 patients l'absence de récidive de douleur après la migration spontanée de la prothèse et sans nouvelle mise en place. Il y a donc deux hypothèses : la première est que, après migration des prothèses l'anastomose pancréaticogastrique reste fonctionnelle, le délai moyen de remplacement des stents était de 5,4 mois

P. Lévy, E. Domínguez-muñoz, C. Imrie, M. Löhr, and P. Maisonneuve, Epidemiology of chronic pancreatitis: burden of the disease and consequences. United, Eur Gastroenterol J. oct, vol.2, issue.5, pp.345-54, 2014.

D. K. Mullady, D. Yadav, S. T. Amann, O. Connell, M. R. Barmada et al., Type of pain, pain-associated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study, Gut. janv, vol.60, issue.1, pp.77-84, 2011.

S. S. Olesen, S. Bouwense, O. Wilder-smith, H. Van-goor, and A. M. Drewes, Pregabalin reduces pain in patients with chronic pancreatitis in a randomized, controlled trial, Gastroenterology. août, vol.141, issue.2, pp.536-579, 2011.

N. Ebbehøj, L. Borly, J. Bülow, S. Grønvall, R. P. Madsen et al., Pancreatic Tissue Fluid Pressure in Chronic Pancreatitis Relation to Pain, Morphology, and Function, Scand J Gastroenterol. janv, vol.25, issue.10, pp.1046-51, 1990.

C. H. Wilder-smith, L. Hill, W. Osler, and S. O'keefe, Effect of tramadol and morphine on pain and gastrointestinal motor function in patients with chronic pancreatitis, Dig Dis Sci. juin, vol.44, issue.6, pp.1107-1123, 1999.

M. Cremer, J. Devière, M. Delhaye, M. Baize, and A. Vandermeeren, Stenting in severe chronic pancreatitis: results of medium-term follow-up in seventy-six patients, Endoscopy. mai, vol.23, issue.3, pp.171-177, 1991.

M. Cremer, J. Deviere, M. Delhaye, A. Vandermeeren, and M. Baize, Non-surgical management of severe chronic pancreatitis, Scand J Gastroenterol Suppl, vol.175, pp.77-84, 1990.

J. Dumonceau, J. Deviere, O. L. Moine, M. Delhaye, A. Vandermeeren et al., Endoscopic pancreatic drainage in chronic pancreatitis associated with ductal stones: longterm results, p.9, 1996.

B. C. Brauer, Y. K. Chen, N. Fukami, and R. J. Shah, Single-operator EUS-guided cholangiopancreatography for difficult pancreaticobiliary access (with video), Gastrointest Endosc. sept, vol.70, issue.3, pp.471-480, 2009.

J. Widmer, R. Z. Sharaiha, and M. Kahaleh, Endoscopic Ultrasonography-Guided Drainage of the Pancreatic Duct, Gastrointest Endosc Clin N Am, vol.23, issue.4, pp.847-61, 2013.

G. Tessier, E. Bories, M. Arvanitakis, A. Hittelet, C. Pesenti et al., EUS-guided pancreatogastrostomy and pancreatobulbostomy for the treatment of pain in patients with pancreatic ductal dilatation inaccessible for transpapillary endoscopic therapy, Gastrointest Endosc. févr, vol.65, issue.2, pp.233-274, 2007.

E. François, M. Kahaleh, M. Giovannini, C. Matos, and J. Devière, EUS-guided pancreaticogastrostomy, Gastrointest Endosc. juill, vol.56, issue.1, pp.128-161, 2002.

A. S. Fink, V. P. De-ayala, M. Chapman, and P. B. Cotton, Radiologic Pitfalls in Endoscopic Retrograde Pancreatography, Pancreas. mars, vol.1, issue.2, pp.180-187, 1986.

D. L. Cahen, E. Rauws, O. R. Busch, M. Dijkgraaf, and M. J. Bruno, Endoscopic versus Surgical Drainage of the Pancreatic Duct in Chronic Pancreatitis, N Engl J Med, vol.9, 2007.

C. E. Lucas, B. Mcintosh, D. Paley, and A. M. Ledgerwood, Surgical decompression of ductal obstruction in patients with chronic pancreatitis, vol.126, p.8, 1999.

D. B. Adams, M. C. Ford, and A. Mc, Outcome After Lateral Pancreaticojejunostomy for Chronic Pancreatitis, Ann Surg. mai, vol.219, issue.5, pp.481-490, 1994.

W. H. Nealon and J. C. Thompson, Progressive Loss of Pancreatic Function in Chronic Pancreatitis Is Delayed by Main Pancreatic Duct Decompression A Longitudinal Prospective Analysis of the Modified Puestow Procedure, Ann Surg. mai, vol.217, issue.5, pp.458-68, 1993.

J. S. Markowitz, D. W. Rattner, and A. L. Warshaw, Failure of symptomatic relief after pancreaticojejunal decompression for chronic pancreatitis. Strategies for salvage. Arch Surg Chic Ill 1960, avr, vol.129, issue.4, pp.374-383, 1994.

K. M. Reid-lombardo, R. Medina, A. Thomsen, K. Harmsen, W. S. Farnell et al., Longterm Anastomotic Complications After Pancreaticoduodenectomy for Benign Diseases, J Gastrointest Surg, vol.11, issue.12, pp.1704-1715, 2007.

H. Amano, T. Takada, B. J. Ammori, H. Yasuda, M. Yoshida et al., Pancreatic duct patency after pancreaticogastrostomy: long-term follow-up study, Hepatogastroenterology. déc, vol.45, issue.24, pp.2382-2389, 1998.

E. Bories, C. Pesenti, F. Caillol, C. Lopes, and M. Giovannini, Transgastric endoscopic ultrasonography-guided biliary drainage: results of a pilot study, Endoscopy. 15 mars, vol.39, issue.04, pp.287-91, 2007.

D. H. Park, S. U. Jeong, B. U. Lee, S. S. Lee, D. Seo et al., Prospective evaluation of a treatment algorithm with enhanced guidewire manipulation protocol for EUS-guided biliary drainage after failed ERCP (with video), Gastrointest Endosc. juill, vol.78, issue.1, pp.91-101, 2013.

O. Barkay, S. Sherman, L. Mchenry, B. M. Yoo, E. L. Fogel et al., Therapeutic EUSassisted endoscopic retrograde pancreatography after failed pancreatic duct cannulation at ERCP, Gastrointest Endosc. juin, vol.71, issue.7, pp.1166-73, 2010.

L. L. Fujii, M. D. Topazian, A. Dayyeh, B. K. Baron, T. H. Chari et al., EUS-guided pancreatic duct intervention: outcomes of a single tertiary-care referral center experience, Gastrointest Endosc. déc, vol.78, issue.6, pp.854-864, 2013.

S. Mallery, J. Matlock, and M. L. Freeman, EUS-guided rendezvous drainage of obstructed biliary and pancreatic ducts: report of 6 cases, Gastrointest Endosc. janv, vol.59, issue.1, pp.100-107, 2004.

U. Will, F. Fueldner, A. Thieme, B. Goldmann, R. Gerlach et al., Transgastric pancreatography and EUS-guided drainage of the pancreatic duct, J Hepatobiliary Pancreat Surg, vol.14, issue.4, pp.377-82, 2007.

M. Kahaleh, A. J. Hernandez, J. Tokar, R. B. Adams, V. M. Shami et al., EUS-guided pancreaticogastrostomy: analysis of its efficacy to drain inaccessible pancreatic ducts, Gastrointest Endosc. févr, vol.65, issue.2, pp.224-254, 2007.

A. Tyberg, R. Z. Sharaiha, P. Kedia, N. Kumta, M. Gaidhane et al., EUS-guided pancreatic drainage for pancreatic strictures after failed ERCP: a multicenter international collaborative study, Gastrointest Endosc. janv, vol.85, issue.1, pp.164-173, 2017.

G. Costamagna, M. Bulajic, A. Tringali, M. Pandolfi, A. Gabbrielli et al., Multiple Stenting of Refractory Pancreatic Duct Strictures in Severe Chronic Pancreatitis: Long-term Results, Endoscopy. 10 mars, vol.38, issue.03, pp.254-263, 2006.

L. Jiang, D. Ning, Q. Cheng, and X. Chen, Endoscopic versus surgical drainage treatment of calcific chronic pancreatitis, Int J Surg. juin, vol.54, pp.242-249, 2018.

T. Rösch, S. Daniel, M. Scholz, K. Huibregtse, M. Smits et al., Endoscopic Treatment of Chronic Pancreatitis: A Multicenter Study of 1000 Patients with Long-Term Follow-Up. Endoscopy, vol.34, pp.765-71, 2002.

M. Delhaye, M. Arvanitakis, G. Verset, M. Cremer, and J. Devière, Long-term clinical outcome after endoscopic pancreatic ductal drainage for patients with painful chronic pancreatitis, Clin Gastroenterol Hepatol. déc, vol.2, issue.12, pp.1096-106, 2004.

T. Ponchon, R. M. Bory, F. Hedelius, L. D. Roubein, P. Paliard et al., Endoscopic stenting for pain relief in chronic pancreatitis: Results of a standardized protocol, Gastrointest Endosc, vol.42, issue.5, pp.452-458, 1995.

Y. I. Chen, M. J. Levy, T. G. Moreels, G. Hajijeva, U. Will et al., An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery, Gastrointest Endosc, vol.85, issue.1, pp.170-177, 2017.

D. Oh, D. H. Park, M. K. Cho, N. K. Song, T. J. Lee et al., Feasibility and safety of a fully covered self-expandable metal stent with antimigration properties for EUS-guided pancreatic duct drainage: early and midterm outcomes (with video), Gastrointest Endosc. févr, vol.83, issue.2, pp.366-373, 2016.

M. Giovannini, Endoscopic ultrasound-guided pancreatic duct drainage: Ready for the prime time? Endosc Ultrasound, vol.6, p.281, 2017.

J. Dumonceau, M. Delhaye, A. Tringali, M. Arvanitakis, A. Sanchez-yague et al., Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Guideline -Updated, Endoscopy. févr, vol.51, issue.02, pp.179-93, 2018.

L. L. Fujii-lau and M. J. Levy, Endoscopic ultrasound-guided pancreatic duct drainage, J Hepatobiliary Pancreat Sci, 2015.

, Abréviations : n: nombre, min-max : minimum-maximum Tableau 3 : Modalités techniques et suivi des patients après traitement endoscopique n=27