One of the most common causes of external pancreatic fistula is the iatrogenic manipulation of a complex pancreatic fluid collection concomitantly associated with a disconnected pancreatic duct [1] [2]. This situation can lead to the development of a high output (up to 400 mL/d) external pancreatic fistula that is difficult to manage and sometimes requires surgery [3]. In 2012, a 40-year-old woman underwent laparoscopic cholecystectomy with a hepaticojejunal Roux-en-Y anastomosis for a congenital Todani’s type IV common bile duct cyst. Postoperative pancreatitis resulted in the development of a complex pancreatic fluid collection in the pancreatic head, which was drained percutaneously. Subsequently, an external pancreatic fistula formed with an output of 200 mL/d. In 2014, the patient was referred to us for further evaluation. Endoscopic retrograde cholangiopancreatography (ERCP) showed a normal main pancreatic duct that lacked a clear communication with the collection ([Fig. 1]). The injection of contrast through the percutaneous catheter showed the presence of a 4-cm fluid collection ([Fig. 2]). Endoscopic ultrasound (EUS)-guided drainage with the placement of plastic stents was planned.

Orellana, F., Attili, F., Andrade Zurita, S., Costamagna, G., Larghi, A., External pancreatic fistula treated by endoscopic ultrasound-guided drainage with a novel lumen-apposing metal stent mounted on a cautery-tipped delivery system, <<ENDOSCOPY>>, 2015; 47 Suppl 1 UCTN (Giugno): E273-E273. [doi:10.1055/s-0034-1391872] [http://hdl.handle.net/10807/71441]

External pancreatic fistula treated by endoscopic ultrasound-guided drainage with a novel lumen-apposing metal stent mounted on a cautery-tipped delivery system

Costamagna, Guido;Larghi, Alberto
2015

Abstract

One of the most common causes of external pancreatic fistula is the iatrogenic manipulation of a complex pancreatic fluid collection concomitantly associated with a disconnected pancreatic duct [1] [2]. This situation can lead to the development of a high output (up to 400 mL/d) external pancreatic fistula that is difficult to manage and sometimes requires surgery [3]. In 2012, a 40-year-old woman underwent laparoscopic cholecystectomy with a hepaticojejunal Roux-en-Y anastomosis for a congenital Todani’s type IV common bile duct cyst. Postoperative pancreatitis resulted in the development of a complex pancreatic fluid collection in the pancreatic head, which was drained percutaneously. Subsequently, an external pancreatic fistula formed with an output of 200 mL/d. In 2014, the patient was referred to us for further evaluation. Endoscopic retrograde cholangiopancreatography (ERCP) showed a normal main pancreatic duct that lacked a clear communication with the collection ([Fig. 1]). The injection of contrast through the percutaneous catheter showed the presence of a 4-cm fluid collection ([Fig. 2]). Endoscopic ultrasound (EUS)-guided drainage with the placement of plastic stents was planned.
Inglese
Orellana, F., Attili, F., Andrade Zurita, S., Costamagna, G., Larghi, A., External pancreatic fistula treated by endoscopic ultrasound-guided drainage with a novel lumen-apposing metal stent mounted on a cautery-tipped delivery system, <>, 2015; 47 Suppl 1 UCTN (Giugno): E273-E273. [doi:10.1055/s-0034-1391872] [http://hdl.handle.net/10807/71441]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/71441
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