Resolving external pancreatic fistulas in patients with disconnected pancreatic duct syndrome: using rendezvous techniques to avoid surgery (with video)

Irani, Shayan; Glück, Michael; Ross, Andrew; Gan, S. Ian; Crane, Robert; Brandabur, John J.; Hauptmann, Ellen; Fotoohi, Mehran; Kozarek, Richard A.

doi:10.1016/j.gie.2012.05.006

Cited by 84 publications

(103 citation statements)

References 37 publications

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“…Previously, some workers have described a rendezvous approach in such difficult cases wherein the percutaneous drainage site was punctured into the gastrointestinal lumen (stomach/duodenum) and the guidewires were captured endoscopically to create a transenetric fistula and stents were placed into the fistula tract close to the pancreatic duct disruption. 3 Occasionally the percutaneous route of drainage may be through a gastrointestinal organs (eg stomach) and this tract can also be used to create an internal drainage to treat EPF. 4 In the present case, we have accomplished the drainage of the fistula tract through a transpapillary stent instead of a percutaneous approach.…”

Section: Discussionmentioning

confidence: 99%

“…2 However, when bridging of disruption is not achieved the EPFs are difficult to treat. While percutaneous modalities have been used previously to place stents into the fistula tract, 3 we describe a case of 55 year old lady who was treated with endoscopic transpapillary placement of stent into the fistula tract thereby creating an endoscopic fistuloduodenostomy.…”

mentioning

confidence: 99%

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Successful treatment of refractory external pancreatic fistula by transpapillary stent insertion into the fistula tract (endoscopic fistuloduodenostomy)

Rana¹

2017

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Successful treatment of refractory external pancreatic fistula by transpapillary stent insertion into the fistula tract (endoscopic fistuloduodenostomy)

Rana¹

2017

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“…Our previous report also found that a sufficient decompression of pancreatic stricture is mandatory for the treatment of patients with IPF 24) . Therefore, there is also the report that combined endoscopic and percutaneous rendezvous technique is the efficient method to reduce the pressure in cases of failure of endoscopic stenting 33) . Although stent therapy has been reported to be more invasive and carries a greater risk than medical therapy, it has been reported to be safer than surgical treatment 25,26) .…”

Section: Discussionmentioning

confidence: 99%

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

Tanaka¹,

Kuroki²,

Kitasato³

et al. 2013

Pancreatology

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Abstract[Background]Internal pancreatic fistula (IPF) is a well-recognized complication of pancreatic diseases. Although there have been many reports concerning IPF, the therapy for IPF still remains controversial. We herein report our experiences with endoscopic transpapillary pancreatic stent therapy for IPF and evaluate its validity.[Method]Six patients with IPF who presented at our department and received endoscopic transpapillary pancreatic stent therapy were investigated, focusing on the clinical and imaging features as well as treatment strategies, the response to therapy and the outcome.[Results]All patients were complicated with stenosis or obstruction of the main pancreatic duct, and in these cases the pancreatic ductal disruption developed distal to the areas of pancreatic stricture. The sites of pancreatic ductal disruption were the pancreatic body in five patients and the pancreatic tail in one patient. All patients received endoscopic stent placement over the stenosis site of the pancreatic duct, and three patients improved completely and one patient improved temporarily. Finally, three patients underwent [Conclusion]Endoscopic transpapillary pancreatic stent therapy may be an appropriate first-line treatment to be considered before surgical treatment. The point of stenting for IPF is to place a stent over the stenosis site of the pancreatic duct to reduce the pancreatic ductal pressure and the pseudocyst's pressure.

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“…К ним относятся: инфициро-вание (нагноение) (15-25 %); перфорация в брюшную полость, в полые органы брюшной полости и наружу (5-15 %); формирование внутренних и наружных сви-щей (5-35 %); обструкция органов брюшной полости вследствие их сдавления с развитием гастродуоде-нальной, тонко-и толстокишечной непроходимости (3-4 %), механической желтухи (5-10 %), портальной гипертензии (4-6 %); канцерогенез (1,7-3,1 %) и другие более редкие осложнения. Наиболее гроз-ным осложнением ПКПЖ, сопряжённым с высоким риском летальности (до 60 %), является аррозивное кровотечение в полость ПКПЖ, брюшную полость и забрюшинную клетчатку [1,2,3,18,26,32,33].…”

Section: актуальностьunclassified

“…По мнению некоторых авторов [19], наилучшие результаты консерватив-ного лечения достижимы до 4 недель с момента об-разования псевдокисты -до стадии так называемых острых жидкостных скоплений, которые не имеют сформированной соединительнотканной капсулы. Консервативное лечение ПКПЖ малых размеров (до 4 см), существующих до 6 недель от эпизода острого панкреатита, без признаков осложнённого течения также является эффективным [18,26,33]. В свою оче-редь, ПКПЖ больших размеров и/или существующие более 6 недель не подвержены спонтанной регрессии [1,14].…”

Section: консервативное лечение пкпжunclassified

Methods of Treatment of Post-Necroctic Pancreatic Cysts: Modern Look at the Problem (Literature Review)

Noskov¹

2017

Acta Biomedica Scientifica

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Choosing a surgical method of treatment of postnecrotic pancreatic cysts is an extremely urgent problem these days. With developing technologies and increasing number of minimally invasive methods of treatment, diagnostic capabilities tend to improve. Whereas traditional methods of surgical treatment do not lose their relevance, recent studies optimize the indications for their implementation, which in turn reduces the frequency of the nearest and distant postoperative complications. The article deals with the questions of conservative therapy of postnecrotic cysts, indications and choice of a method of surgical treatment. It covers the methods of minimally invasive surgery, the application of which allows achieving excellent clinical results of treatment The authors pays particular attention to the recent tendency of using several methods of minimally invasive treatment describing that the combination of minimally invasive internal and external drainage has shown its effectiveness. It should be noted that performing intervention data from the position of pathogenetic treatment helps to achieve a good clinical result. The data on АКТУАЛЬНОСТЬАктуальность темы обусловлена ежегодным увеличением заболеваемости острым панкреатитом как в Российской Федерации, так и в большинстве раз-витых стран мира. В структуре смертности от острой хирургической патологии в Красноярском крае в последние годы смертность от острого панкреатита занимает первое место и составляет более 30 % [7].Одним из осложнений перенесённого острого панкреатита является постнекротическая киста (ПК) поджелудочной железы (ПЖ) (псевдокиста).По различным данным, острый панкреатит и панкреонекроз осложняются формированием ПКПЖ в 7-80 % случаев [16,20]. Образование ПКПЖ необхо-димо рассматривать как благоприятный исход тече-ния панкреонекроза, который существенно снижает

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Resolving external pancreatic fistulas in patients with disconnected pancreatic duct syndrome: using rendezvous techniques to avoid surgery (with video)

Cited by 84 publications

References 37 publications

Successful treatment of refractory external pancreatic fistula by transpapillary stent insertion into the fistula tract (endoscopic fistuloduodenostomy)

Successful treatment of refractory external pancreatic fistula by transpapillary stent insertion into the fistula tract (endoscopic fistuloduodenostomy)

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

Methods of Treatment of Post-Necroctic Pancreatic Cysts: Modern Look at the Problem (Literature Review)

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