Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center
| Autor: | Brian Moloney, Savio Reddymasu, Mojtaba Olyaee, Benjamin R. Alsop, Melissa Oropezia-Vail, Kavous Pakseresht |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Published online: August 2013 Distal pancreatectomy Tertiary care Pancreatic stent Pancreatic duct stenting Pancreatic duct stent Medicine lcsh:RC799-869 Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Incidence (epidemiology) General surgery Gastroenterology medicine.disease digestive system diseases Surgery Pancreatic leak surgical procedures operative Pancreatic fistula lcsh:Diseases of the digestive system. Gastroenterology Complication business |
| Zdroj: | Case Reports in Gastroenterology, Vol 7, Iss 2, Pp 332-339 (2013) Case Reports in Gastroenterology |
| ISSN: | 1662-0631 |
| DOI: | 10.1159/000354136 |
| Popis: | Pancreatic fistula is a known complication of distal pancreatectomy. Endotherapy with pancreatic duct stent placement and pancreatic sphincterotomy has been shown to be effective in its management; however, experience of endotherapy in the management of this complication has not been extensively reported from the United States. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic stent placement has also been proposed to prevent this complication after distal pancreatectomy. In our cohort of 59 patients who underwent distal pancreatectomy, 13 (22%) developed a pancreatic fistula in the immediate postoperative period, of whom 8 (14%) patients (5 female, mean age 52 years) were referred for an ERCP because of ongoing symptoms related to the pancreatic fistula. The pancreatic fistula resolved in all patients after a median duration of 62 days from the index ERCP. The median number of ERCPs required to document resolution of the pancreatic fistula was 2. Although a sizeable percentage of patients develop a pancreatic fistula after distal pancreatectomy, only a small percentage of patients require ERCP for management of this complication. Given the high success rate of endotherapy in resolving pancreatic fistula and the fact that the majority of patients who undergo distal pancreatectomy never require an ERCP, performing ERCP for prophylactic pancreatic duct stent prior to distal pancreatectomy might not be necessary. |
| Databáze: | OpenAIRE |
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