Endoscopic ultrasound-guided pancreatogastrostomy (EUS-PG) can be indicated for patients with pancreatic obstruction after a failed endoscopic retrograde cholangiopancreatography (ERCP) [1] [2] [3]. The technical steps of EUS-PG include pancreatic duct puncture, guidewire deployment, tract dilation, and stent deployment. Notably, compared with the EUS-guided transhepatic approach, the echoendoscope is not stable because its upper angle is not as strong during EUS-PG. During device insertion, such as stent deployment, this instability may lead to inadequate axis and cause performing EUS-PG to be more challenging.
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Matsuno et al. (2025) studied this question.
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