Endoscopic transpapillary pancreatic stenting for internal pancreatic fistula with the disruption of the pancreatic ductal system

Tanaka, Takayuki; Kuroki, Tamotsu; Kitasato, Amane; Adachi, Tomohiko; Ono, Satoshi; Hirabaru, Masataka; Matsushima, Hajime; Takatsuki, Mitsuhisa; Eguchi, Susumu

doi:10.1016/j.pan.2013.08.006

Cited by 20 publications

(11 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The advent of ERCP has allowed endoscopists to place transpapillary stents to facilitate leak closure (Fig. ) . This intervention, combined with other therapeutic endoscopy techniques, has allowed many patients to avoid surgery.…”

Section: Managementmentioning

confidence: 99%

See 1 more Smart Citation

Management of pancreatic ductal leaks and fistulae

Larsen

Kozarek

2014

J of Gastro and Hepatol

View full text Add to dashboard Cite

Pancreatic duct leaks can occur as a result of both acute and chronic pancreatitis or in the setting of pancreatic trauma. Manifestations of leaks include pseudocysts, pancreatic ascites, high amylase pleural effusions, disconnected duct syndrome, and internal and external pancreatic fistulas. Patient presentations are highly variable and range from asymptomatic pancreatic cysts to patients with severe abdominal pain and sepsis from infected fluid collections. The diagnosis can often be made by high-quality cross-sectional imaging or during endoscopic retrograde cholangiopancreatography (ERCP). Because of their complexity, pancreatic leak patients are best managed by a multidisciplinary team comprised of therapeutic endoscopists, interventional radiologists, and surgeons in the field of pancreatic interventions. Minor leaks will often resolve with conservative management while severe leaks will frequently require interventions. Endoscopic treatments for pancreatic duct leaks have replaced surgical interventions in many situations. Interventional radiologists also have the ability to offer therapeutic interventions for many leak patients. The mainstay of endotherapy for pancreatic leaks is transpapillary pancreatic duct stenting with a stent that bridges the leak if possible, but varies based on the manifestation and clinical presentation. Fluid collections that result from leaks, such as pseudocysts, can often be treated by endoscopic transluminal drainage with or without endoscopic ultrasound or by percutaneous drainage. Endoscopic interventions have been shown to be effective and have an acceptable complication rate.

show abstract

Section: Managementmentioning

confidence: 99%

“…1). 21,22 This intervention, combined with other therapeutic endoscopy techniques, has allowed many patients to avoid surgery. Pancreatic stenting is effective in treating pancreatic leaks because it returns flow of pancreatic juices into the duodenum rather than through the duct disruption; therefore allowing the leak to heal.…”

Section: Managementmentioning

confidence: 99%

Management of pancreatic ductal leaks and fistulae

Larsen

Kozarek

2014

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…ERCP is an important modality in PPF as it provides both diagnostic as well as therapeutic options 6 7. In our patient, clinical suspicion of PPF and demonstration of tract on CT imaging, established the diagnosis.…”

Section: Discussionmentioning

confidence: 57%

Pancreaticopericardial fistula: a rare complication of chronic pancreatitis

et al. 2016

View full text Add to dashboard Cite

Pancreaticopericardial fistula (PPF) is an extremely rare clinical problem encountered in patients with chronic pancreatitis. The diagnosis should be suspected if a patient presents with pericardial effusion on a background of chronic pancreatitis. Significantly raised amylase in the pericardial fluid offers an important clue for the diagnosis. CT is the initial imaging modality to look for pancreatic and pericardial changes. The therapeutic options include medical, endoscopic or surgical interventions. Medical and endoscopic therapies are the preferred modes of treatment while surgery is reserved for those who fail these measures.

show abstract

“…Pancreatic sphincterotomy can then be performed, followed by the placement of a temporary pancreatic stent . If the location of the leak can be identified that segment of the main pancreatic duct should be bridged with a stent …”

Section: Discussionmentioning

confidence: 99%