Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center
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 rep...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2013-08-01
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| Series: | Case Reports in Gastroenterology |
| Subjects: | |
| Online Access: | http://www.karger.com/Article/FullText/354136 |
| _version_ | 1811312411796307968 |
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| author | Savio C. Reddymasu Kavous Pakseresht Brian Moloney Benjamin Alsop Melissa Oropezia-Vail Mojtaba Olyaee |
| author_facet | Savio C. Reddymasu Kavous Pakseresht Brian Moloney Benjamin Alsop Melissa Oropezia-Vail Mojtaba Olyaee |
| author_sort | Savio C. Reddymasu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T10:35:46Z |
| format | Article |
| id | doaj.art-326ac8a20f0a4d43a0b34d5e979ff50f |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-04-13T10:35:46Z |
| publishDate | 2013-08-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-326ac8a20f0a4d43a0b34d5e979ff50f2022-12-22T02:50:03ZengKarger PublishersCase Reports in Gastroenterology1662-06312013-08-017233233910.1159/000354136354136Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care CenterSavio C. ReddymasuKavous PaksereshtBrian MoloneyBenjamin AlsopMelissa Oropezia-VailMojtaba OlyaeePancreatic 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.http://www.karger.com/Article/FullText/354136Distal pancreatectomyPancreatic fistulaPancreatic leakPancreatic duct stenting |
| spellingShingle | Savio C. Reddymasu Kavous Pakseresht Brian Moloney Benjamin Alsop Melissa Oropezia-Vail Mojtaba Olyaee Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center Case Reports in Gastroenterology Distal pancreatectomy Pancreatic fistula Pancreatic leak Pancreatic duct stenting |
| title | Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center |
| title_full | Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center |
| title_fullStr | Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center |
| title_full_unstemmed | Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center |
| title_short | Incidence of Pancreatic Fistula after Distal Pancreatectomy and Efficacy of Endoscopic Therapy for Its Management: Results from a Tertiary Care Center |
| title_sort | incidence of pancreatic fistula after distal pancreatectomy and efficacy of endoscopic therapy for its management results from a tertiary care center |
| topic | Distal pancreatectomy Pancreatic fistula Pancreatic leak Pancreatic duct stenting |
| url | http://www.karger.com/Article/FullText/354136 |
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