Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis
Pancreatic fistulas belong to the most feared complications after surgery on or near the pancreas, abdominal trauma, or severe pancreatitis. The majority occur in the setting of operative interventions and are called postoperative pancreatic fistulas (POPF). They can lead to various complications, i...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/13/4531 |
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| author | Clara Meierhofer Reinhold Fuegger Georg O. Spaun Helwig Valentin Wundsam Patrick Kirchweger Matthias Biebl Rainer Schoefl |
| author_facet | Clara Meierhofer Reinhold Fuegger Georg O. Spaun Helwig Valentin Wundsam Patrick Kirchweger Matthias Biebl Rainer Schoefl |
| author_sort | Clara Meierhofer |
| collection | DOAJ |
| description | Pancreatic fistulas belong to the most feared complications after surgery on or near the pancreas, abdominal trauma, or severe pancreatitis. The majority occur in the setting of operative interventions and are called postoperative pancreatic fistulas (POPF). They can lead to various complications, including abscesses, delayed gastric emptying or hemorrhages with a significant impact on morbidity and mortality. Several risk factors have been identified, including smoking, high BMI, male gender, and age. Prophylactic measures and treatment options have been explored but with limited success. This study aimed to analyze the incidence and management of pancreatic fistulas treated in a tertiary referral center, particularly focusing on an endoscopic approach. The data of 60 patients with clinically relevant pancreatic fistulas were analyzed between 2018 and 2021. Different treatment approaches, including conservative management, percutaneous drainage, transpapillary stenting, and endoscopic transmural drainage, were evaluated. An endoscopic transmural approach using lumen-apposing metal stents (LAMS) was used in almost half of this cohort showing promising results, with a high rate of fistula closure in refractory cases and a mean time until closure of 2.7 months. The findings suggest that an endoscopic approach, particularly using LAMS, can be effective in the management of pancreatic fistulas. |
| first_indexed | 2024-03-11T01:37:29Z |
| format | Article |
| id | doaj.art-c29acabdc2e84a88ba4cdf0e5f790cf6 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T01:37:29Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c29acabdc2e84a88ba4cdf0e5f790cf62023-11-18T16:55:12ZengMDPI AGJournal of Clinical Medicine2077-03832023-07-011213453110.3390/jcm12134531Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data AnalysisClara Meierhofer0Reinhold Fuegger1Georg O. Spaun2Helwig Valentin Wundsam3Patrick Kirchweger4Matthias Biebl5Rainer Schoefl6Department of Gastroenterology, Ordensklinikum Barmherzige Schwestern Linz, 4010 Linz, AustriaDepartment of Surgery, Ordensklinikum Linz Barmherzige Schwestern, 4010 Linz, AustriaDepartment of Surgery, Ordensklinikum Linz Barmherzige Schwestern, 4010 Linz, AustriaDepartment of Surgery, Ordensklinikum Linz Barmherzige Schwestern, 4010 Linz, AustriaDepartment of Surgery, Ordensklinikum Linz Barmherzige Schwestern, 4010 Linz, AustriaDepartment of Surgery, Ordensklinikum Linz Barmherzige Schwestern, 4010 Linz, AustriaDepartment of Gastroenterology, Ordensklinikum Barmherzige Schwestern Linz, 4010 Linz, AustriaPancreatic fistulas belong to the most feared complications after surgery on or near the pancreas, abdominal trauma, or severe pancreatitis. The majority occur in the setting of operative interventions and are called postoperative pancreatic fistulas (POPF). They can lead to various complications, including abscesses, delayed gastric emptying or hemorrhages with a significant impact on morbidity and mortality. Several risk factors have been identified, including smoking, high BMI, male gender, and age. Prophylactic measures and treatment options have been explored but with limited success. This study aimed to analyze the incidence and management of pancreatic fistulas treated in a tertiary referral center, particularly focusing on an endoscopic approach. The data of 60 patients with clinically relevant pancreatic fistulas were analyzed between 2018 and 2021. Different treatment approaches, including conservative management, percutaneous drainage, transpapillary stenting, and endoscopic transmural drainage, were evaluated. An endoscopic transmural approach using lumen-apposing metal stents (LAMS) was used in almost half of this cohort showing promising results, with a high rate of fistula closure in refractory cases and a mean time until closure of 2.7 months. The findings suggest that an endoscopic approach, particularly using LAMS, can be effective in the management of pancreatic fistulas.https://www.mdpi.com/2077-0383/12/13/4531pancreasfistulasurgeryinterventional endoscopytransmural drainage |
| spellingShingle | Clara Meierhofer Reinhold Fuegger Georg O. Spaun Helwig Valentin Wundsam Patrick Kirchweger Matthias Biebl Rainer Schoefl Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis Journal of Clinical Medicine pancreas fistula surgery interventional endoscopy transmural drainage |
| title | Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis |
| title_full | Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis |
| title_fullStr | Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis |
| title_full_unstemmed | Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis |
| title_short | Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis |
| title_sort | endoscopic transmural therapy of pancreatic fistulas in an interdisciplinary setting a retrospective data analysis |
| topic | pancreas fistula surgery interventional endoscopy transmural drainage |
| url | https://www.mdpi.com/2077-0383/12/13/4531 |
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