Endotherapy of pancreaticopleural fistulas- a single-center experience.
EAES Academy. Jagielski M. 07/05/22; 363073; P118
Prof. Dr. Mateusz Jagielski
Contributions
Contributions
Abstract
Aims:
Pancreaticopleural fistula is a serious complication of acute and chronic pancreatitis. Assessment of efficacy of various endoscopic techniques in treatment of patients with pancreaticopleural fistula.
Methods:
Prospective analysis of endoscopic treatment of all consecutive 22 patients with pancreaticopleural fistulas in the course of pancreatitis in years 2018-2021 in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland.
Results:
In 22 patients (21 males, 1 female; average age 49,52 [30-67] years) with pancreatitis pancreaticopleural fistulas were diagnosed. In 19/22 (86.36%) patients fistula communicated with left pleural cavity; in 3/22 (13.64%) patients with right pleural cavity. In all 22 cases drainage of pleural cavity was performed. Chronic pancreatitis was recognized in 14/22 (63.64%) cases. In 15/22 (68.18%) patients with pancreaticopleural fistulas symptomatic pancreatic and peripancreatic collections (PPFCs) were diagnosed (11 patients with pseudocyst and 4 patients with walled-off pancreatic necrosis). In 21/22 (95.45%) cases endoscopic retrograde pancreatography (ERP) was performed, during which the presence of fistula was confirmed. In all 21 patients endoscopic sphincterotomy with stenting of main pancreatic duct was performed (passive transpapillary drainage). In 1/22 (4.55%) patient active treansmural drainage of pancreaticopleural fistula was performed due to inflammatory infiltration of peripapillary area preventing performance of ERP. Additionally, in all 15 patients transmural endoscopic drainage of PPFCs was performed. Clinical success was achieved in 21/22 (95.45%) cases. Total endotherapy period was average 191 (88-712) days. Long-term success in endoscopic treatment of pancreaticopleural fistulas was stated in 19/22 (86.36%) patients.
Conclusion:
Endoscopic treatment of post-inflammatory pancreaticopleural fistulas is an effective method of treatment.
Pancreaticopleural fistula is a serious complication of acute and chronic pancreatitis. Assessment of efficacy of various endoscopic techniques in treatment of patients with pancreaticopleural fistula.
Methods:
Prospective analysis of endoscopic treatment of all consecutive 22 patients with pancreaticopleural fistulas in the course of pancreatitis in years 2018-2021 in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland.
Results:
In 22 patients (21 males, 1 female; average age 49,52 [30-67] years) with pancreatitis pancreaticopleural fistulas were diagnosed. In 19/22 (86.36%) patients fistula communicated with left pleural cavity; in 3/22 (13.64%) patients with right pleural cavity. In all 22 cases drainage of pleural cavity was performed. Chronic pancreatitis was recognized in 14/22 (63.64%) cases. In 15/22 (68.18%) patients with pancreaticopleural fistulas symptomatic pancreatic and peripancreatic collections (PPFCs) were diagnosed (11 patients with pseudocyst and 4 patients with walled-off pancreatic necrosis). In 21/22 (95.45%) cases endoscopic retrograde pancreatography (ERP) was performed, during which the presence of fistula was confirmed. In all 21 patients endoscopic sphincterotomy with stenting of main pancreatic duct was performed (passive transpapillary drainage). In 1/22 (4.55%) patient active treansmural drainage of pancreaticopleural fistula was performed due to inflammatory infiltration of peripapillary area preventing performance of ERP. Additionally, in all 15 patients transmural endoscopic drainage of PPFCs was performed. Clinical success was achieved in 21/22 (95.45%) cases. Total endotherapy period was average 191 (88-712) days. Long-term success in endoscopic treatment of pancreaticopleural fistulas was stated in 19/22 (86.36%) patients.
Conclusion:
Endoscopic treatment of post-inflammatory pancreaticopleural fistulas is an effective method of treatment.
Aims:
Pancreaticopleural fistula is a serious complication of acute and chronic pancreatitis. Assessment of efficacy of various endoscopic techniques in treatment of patients with pancreaticopleural fistula.
Methods:
Prospective analysis of endoscopic treatment of all consecutive 22 patients with pancreaticopleural fistulas in the course of pancreatitis in years 2018-2021 in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland.
Results:
In 22 patients (21 males, 1 female; average age 49,52 [30-67] years) with pancreatitis pancreaticopleural fistulas were diagnosed. In 19/22 (86.36%) patients fistula communicated with left pleural cavity; in 3/22 (13.64%) patients with right pleural cavity. In all 22 cases drainage of pleural cavity was performed. Chronic pancreatitis was recognized in 14/22 (63.64%) cases. In 15/22 (68.18%) patients with pancreaticopleural fistulas symptomatic pancreatic and peripancreatic collections (PPFCs) were diagnosed (11 patients with pseudocyst and 4 patients with walled-off pancreatic necrosis). In 21/22 (95.45%) cases endoscopic retrograde pancreatography (ERP) was performed, during which the presence of fistula was confirmed. In all 21 patients endoscopic sphincterotomy with stenting of main pancreatic duct was performed (passive transpapillary drainage). In 1/22 (4.55%) patient active treansmural drainage of pancreaticopleural fistula was performed due to inflammatory infiltration of peripapillary area preventing performance of ERP. Additionally, in all 15 patients transmural endoscopic drainage of PPFCs was performed. Clinical success was achieved in 21/22 (95.45%) cases. Total endotherapy period was average 191 (88-712) days. Long-term success in endoscopic treatment of pancreaticopleural fistulas was stated in 19/22 (86.36%) patients.
Conclusion:
Endoscopic treatment of post-inflammatory pancreaticopleural fistulas is an effective method of treatment.
Pancreaticopleural fistula is a serious complication of acute and chronic pancreatitis. Assessment of efficacy of various endoscopic techniques in treatment of patients with pancreaticopleural fistula.
Methods:
Prospective analysis of endoscopic treatment of all consecutive 22 patients with pancreaticopleural fistulas in the course of pancreatitis in years 2018-2021 in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland.
Results:
In 22 patients (21 males, 1 female; average age 49,52 [30-67] years) with pancreatitis pancreaticopleural fistulas were diagnosed. In 19/22 (86.36%) patients fistula communicated with left pleural cavity; in 3/22 (13.64%) patients with right pleural cavity. In all 22 cases drainage of pleural cavity was performed. Chronic pancreatitis was recognized in 14/22 (63.64%) cases. In 15/22 (68.18%) patients with pancreaticopleural fistulas symptomatic pancreatic and peripancreatic collections (PPFCs) were diagnosed (11 patients with pseudocyst and 4 patients with walled-off pancreatic necrosis). In 21/22 (95.45%) cases endoscopic retrograde pancreatography (ERP) was performed, during which the presence of fistula was confirmed. In all 21 patients endoscopic sphincterotomy with stenting of main pancreatic duct was performed (passive transpapillary drainage). In 1/22 (4.55%) patient active treansmural drainage of pancreaticopleural fistula was performed due to inflammatory infiltration of peripapillary area preventing performance of ERP. Additionally, in all 15 patients transmural endoscopic drainage of PPFCs was performed. Clinical success was achieved in 21/22 (95.45%) cases. Total endotherapy period was average 191 (88-712) days. Long-term success in endoscopic treatment of pancreaticopleural fistulas was stated in 19/22 (86.36%) patients.
Conclusion:
Endoscopic treatment of post-inflammatory pancreaticopleural fistulas is an effective method of treatment.
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