Endoscopic transpapillary drainage for external fistulas developing after surgical or radiological pancreatic interventions

Abstract

External pancreatic fistulas developing following percutaneous drainage of pancreatic fluid collections or surgical necrosectomy can be effectively treated by transpapillary nasopancreatic drain placement especially when there is partial ductal disruption and the disruption can be bridged.

Endotherapy of external pancreatic fistula: Second‐to‐none choice for cure

“…In conclusion, the results of the study reported by Rana and colleagues in this issue of Journal of Gastroenterology and Hepatology is encouraging; 13 it confirms that endoscopic treatment of patients with EPF can often avoid an aggressive surgical approach and could be useful as a first‐line therapy when conservative treatment is unsuccessful. Precise knowledge of pancreatic duct anatomy is mandatory to ensure technical success, and this procedure should be performed by an expert.…”

“…In this issue of Journal of Gastroenterology and Hepatology , Rana et al 13 . report their interesting experience of 12 years of EPF treatment.…”

Comparative Evaluation of Transpapillary Drainage with Nasopancreatic Drain and Stent in Patients with Large Pseudocysts Located Near Tail of Pancreas

“…In our earlier studies also, we have noted that some of the patients with complete disruption had also the resolution of the pseudocysts/ fistulae after non-bridging transpapillary drainage although the results were not as spectacular as were noted in patients with partial disruption. 8,9,14,17 Another large study by Varadarajulu et al also reported successful resolution after transpapillary drainage in 26% (6/23) of patients with complete disruption. 18 The reason for resolution of pseudocysts in this situation is not clear, and further studies are needed.…”

Severe Acute Pancreatitis with Complicating Colonic Fistula Successfully Closed Using the Over-the-Scope Clip System

“…In recent years, endoscopic treatment has proven to be an effective alternative to surgical techniques for pancreatic duct disruption [2]. Currently, the standard treatment for colonic perforation is open surgical repair.…”