PDF herunterladen
CC BY 4.0 · Journal of Digestive Endoscopy 2024; 15(03): 174-183
DOI: 10.1055/s-0044-1788712
Review Article

Role of Endoscopy in Managing Complications Associated with Pancreaticoduodenectomy: Concise Review of Literature

Rahul Puri   *
1   Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
,
Akhil Mahajan    *
1   Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
,
Sridhar Sundaram
1   Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Pancreaticoduodenectomy (PD) is a complex surgery for the management of periampullary tumors. It is associated with significant morbidity and mortality of 20% and 3 to 5% respectively. While early complications like delayed gastric emptying, hemorrhage, and collections are common, late complications like biliary and pancreatic anastomotic stenosis are also known to occur. With the increase in cases of pancreatic and periampullary cancers, there is an upward trend seen even in the rates of surgery. Endoscopy has emerged over the years as a tool for both evaluation and management of various complications. In this narrative review, we aim to provide a primer for gastroenterologists who are likely to be called upon for endoscopic management of post-PD complications.

Keywords

complications - endoscopy - pancreaticoduodenectomy

* Co-first authors.




Publikationsverlauf

Artikel online veröffentlicht:
29. Juli 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Leichtle SW, Kaoutzanis C, Mouawad NJ. et al. Classic Whipple versus pylorus-preserving pancreaticoduodenectomy in the ACS NSQIP. J Surg Res 2013; 183 (01) 170-176
    CrossrefPubMedSuche in Google Scholar
  • 2 Crist DW, Sitzmann JV, Cameron JL. Improved hospital morbidity, mortality, and survival after the Whipple procedure. Ann Surg 1987; 206 (03) 358-365
    CrossrefPubMedSuche in Google Scholar
  • 3 Shrikhande SV, Barreto SG, Somashekar BA. et al. Evolution of pancreatoduodenectomy in a tertiary cancer center in India: improved results from service reconfiguration. Pancreatology 2013; 13 (01) 63-71
    CrossrefPubMedSuche in Google Scholar
  • 4 Barakat MT, Adler DG. Endoscopy in patients with surgically altered anatomy. Am J Gastroenterol 2021; 116 (04) 657-665
    CrossrefPubMedSuche in Google Scholar
  • 5 Trede M, Schwall G. The complications of pancreatectomy. Ann Surg 1988; 207 (01) 39-47
    CrossrefPubMedSuche in Google Scholar
  • 6 Rumstadt B, Schwab M, Korth P, Samman M, Trede M. Hemorrhage after pancreatoduodenectomy. Ann Surg 1998; 227 (02) 236-241
    CrossrefPubMedSuche in Google Scholar
  • 7 Reber PU, Baer HU, Patel AG, Triller J, Büchler MW. Life-threatening upper gastrointestinal tract bleeding caused by ruptured extrahepatic pseudoaneurysm after pancreatoduodenectomy. Surgery 1998; 124 (01) 114-115
    CrossrefPubMedSuche in Google Scholar
  • 8 Balachandran P, Sikora SS, Raghavendra Rao RV, Kumar A, Saxena R, Kapoor VK. Haemorrhagic complications of pancreaticoduodenectomy. ANZ J Surg 2004; 74 (11) 945-950
    CrossrefPubMedSuche in Google Scholar
  • 9 Yekebas EF, Wolfram L, Cataldegirmen G. et al. Postpancreatectomy hemorrhage: diagnosis and treatment: an analysis in 1669 consecutive pancreatic resections. Ann Surg 2007; 246 (02) 269-280
    CrossrefPubMedSuche in Google Scholar
  • 10 Limongelli P, Khorsandi SE, Pai M. et al. Management of delayed postoperative hemorrhage after pancreaticoduodenectomy: a meta-analysis. Arch Surg 2008; 143 (10) 1001-1007 , discussion 1007
    CrossrefPubMedSuche in Google Scholar
  • 11 Katz S, Lazar L, Rathaus V, Erez I. Can ultrasonography replace computed tomography in the initial assessment of children with blunt abdominal trauma?. J Pediatr Surg 1996; 31 (05) 649-651
    CrossrefPubMedSuche in Google Scholar
  • 12 Feng J, Chen YL, Dong JH, Chen MY, Cai SW, Huang ZQ. Post-pancreaticoduodenectomy hemorrhage: risk factors, managements and outcomes. Hepatobiliary Pancreat Dis Int 2014; 13 (05) 513-522
    CrossrefPubMedSuche in Google Scholar
  • 13 Zhou TY, Sun JH, Zhang YL. et al. Post-pancreaticoduodenectomy hemorrhage: DSA diagnosis and endovascular treatment. Oncotarget 2017; 8 (43) 73684-73692 [published correction appears in Oncotarget 2018;9(20):15436]
    CrossrefPubMedSuche in Google Scholar
  • 14 Habib JR, Gao S, Young AJ. et al. Incidence and contemporary management of delayed bleeding following pancreaticoduodenectomy. World J Surg 2022; 46 (05) 1161-1171
    CrossrefPubMedSuche in Google Scholar
  • 15 Giuliano K, Ejaz A, He J. Technical aspects of pancreaticoduodenectomy and their outcomes. Chin Clin Oncol 2017; 6 (06) 64
    CrossrefPubMedSuche in Google Scholar
  • 16 Nakamura T, Ambo Y, Noji T. et al. Reduction of the incidence of delayed gastric emptying in side-to-side gastrojejunostomy in subtotal stomach-preserving pancreaticoduodenectomy. J Gastrointest Surg 2015; 19 (08) 1425-1432
    CrossrefPubMedSuche in Google Scholar
  • 17 Kim DK, Hindenburg AA, Sharma SK. et al. Is pylorospasm a cause of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy?. Ann Surg Oncol 2005; 12 (03) 222-227
    CrossrefPubMedSuche in Google Scholar
  • 18 Eisenberg JD, Rosato EL, Lavu H, Yeo CJ, Winter JM. Delayed gastric emptying after pancreaticoduodenectomy: an analysis of risk factors and cost. J Gastrointest Surg 2015; 19 (09) 1572-1580
    CrossrefPubMedSuche in Google Scholar
  • 19 Wente MN, Bassi C, Dervenis C. et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 2007; 142 (05) 761-768
    CrossrefPubMedSuche in Google Scholar
  • 20 Patel AG, Toyama MT, Kusske AM, Alexander P, Ashley SW, Reber HA. Pylorus-preserving Whipple resection for pancreatic cancer. Is it any better?. Arch Surg 1995; 130 (08) 838-842 , discussion 842–843
    CrossrefPubMedSuche in Google Scholar
  • 21 Lin PW, Lin YJ. Prospective randomized comparison between pylorus-preserving and standard pancreaticoduodenectomy. Br J Surg 1999; 86 (05) 603-607
    CrossrefPubMedSuche in Google Scholar
  • 22 Qu H, Sun GR, Zhou SQ, He QS. Clinical risk factors of delayed gastric emptying in patients after pancreaticoduodenectomy: a systematic review and meta-analysis. Eur J Surg Oncol 2013; 39 (03) 213-223
    CrossrefPubMedSuche in Google Scholar
  • 23 Yeo CJ, Barry MK, Sauter PK. et al. Erythromycin accelerates gastric emptying after pancreaticoduodenectomy. A prospective, randomized, placebo-controlled trial. Ann Surg 1993; 218 (03) 229-237 , discussion 237–238
    CrossrefPubMedSuche in Google Scholar
  • 24 Calogero, Cristina, Chalikonda, et al. Endoscopic management of post-pancreaticoduodenectomy delayed gastric emptying. Am J Gastroenterol 2020; 115 (02) S259
    CrossrefSuche in Google Scholar
  • 25 Lillemoe KD, Kaushal S, Cameron JL, Sohn TA, Pitt HA, Yeo CJ. Distal pancreatectomy: indications and outcomes in 235 patients. Ann Surg 1999; 229 (05) 693-698 , discussion 698–700
    CrossrefPubMedSuche in Google Scholar
  • 26 Balcom IV JH, Rattner DW, Warshaw AL, Chang Y, Fernandez-del Castillo C. Ten-year experience with 733 pancreatic resections: changing indications, older patients, and decreasing length of hospitalization. Arch Surg 2001; 136 (04) 391-398
    CrossrefPubMedSuche in Google Scholar
  • 27 Briggs CD, Mann CD, Irving GR. et al. Systematic review of minimally invasive pancreatic resection. J Gastrointest Surg 2009; 13 (06) 1129-1137
    CrossrefPubMedSuche in Google Scholar
  • 28 Shimizu S, Tanaka M, Konomi H, Mizumoto K, Yamaguchi K. Laparoscopic pancreatic surgery: current indications and surgical results. Surg Endosc 2004; 18 (03) 402-406
    CrossrefPubMedSuche in Google Scholar
  • 29 Pannegeon V, Pessaux P, Sauvanet A, Vullierme MP, Kianmanesh R, Belghiti J. Pancreatic fistula after distal pancreatectomy: predictive risk factors and value of conservative treatment. Arch Surg 2006; 141 (11) 1071-1076 , discussion 1076
    CrossrefPubMedSuche in Google Scholar
  • 30 Harnoss JC, Ulrich AB, Harnoss JM, Diener MK, Büchler MW, Welsch T. Use and results of consensus definitions in pancreatic surgery: a systematic review. Surgery 2014; 155 (01) 47-57
    CrossrefPubMedSuche in Google Scholar
  • 31 Bassi C, Dervenis C, Butturini G. et al; International Study Group on Pancreatic Fistula Definition. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005; 138 (01) 8-13
    CrossrefPubMedSuche in Google Scholar
  • 32 Bassi C, Marchegiani G, Dervenis C. et al; International Study Group on Pancreatic Surgery (ISGPS). The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 2017; 161 (03) 584-591
    CrossrefPubMedSuche in Google Scholar
  • 33 Kwon YM, Gerdes H, Schattner MA. et al. Management of peripancreatic fluid collections following partial pancreatectomy: a comparison of percutaneous versus EUS-guided drainage. Surg Endosc 2013; 27 (07) 2422-2427
    CrossrefPubMedSuche in Google Scholar
  • 34 Téllez-Ávila F, Carmona-Aguilera GJ, Valdovinos-Andraca F. et al. Postoperative abdominal collections drainage: percutaneous versus guided by endoscopic ultrasound. Dig Endosc 2015; 27 (07) 762-766
    CrossrefPubMedSuche in Google Scholar
  • 35 Fotoohi M, D'Agostino HB, Wollman B, Chon K, Shahrokni S, vanSonnenberg E. Persistent pancreatocutaneous fistula after percutaneous drainage of pancreatic fluid collections: role of cause and severity of pancreatitis. Radiology 1999; 213 (02) 573-578
    CrossrefPubMedSuche in Google Scholar
  • 36 Azeem N, Baron TH, Topazian MD, Zhong N, Fleming CJ, Kendrick ML. Outcomes of endoscopic and percutaneous drainage of pancreatic fluid collections arising after pancreatic tail resection. J Am Coll Surg 2012; 215 (02) 177-185
    CrossrefPubMedSuche in Google Scholar
  • 37 Al Efishat M, Attiyeh MA, Eaton AA. et al. Endoscopic versus percutaneous drainage of post-operative peripancreatic fluid collections following pancreatic resection. HPB (Oxford) 2019; 21 (04) 434-443
    CrossrefPubMedSuche in Google Scholar
  • 38 Varadarajulu S, Christein JD, Tamhane A, Drelichman ER, Wilcox CM. Prospective randomized trial comparing EUS and EGD for transmural drainage of pancreatic pseudocysts (with videos). Gastrointest Endosc 2008; 68 (06) 1102-1111
    CrossrefPubMedSuche in Google Scholar
  • 39 Woo DH, Lee JH, Park YJ. et al. Comparison of endoscopic ultrasound-guided drainage and percutaneous catheter drainage of postoperative fluid collection after pancreaticoduodenectomy. Ann Hepatobiliary Pancreat Surg 2022; 26 (04) 355-362
    CrossrefPubMedSuche in Google Scholar
  • 40 Ramouz A, Shafiei S, Ali-Hasan-Al-Saegh S. et al. Systematic review and meta-analysis of endoscopic ultrasound drainage for the management of fluid collections after pancreas surgery. Surg Endosc 2022; 36 (06) 3708-3720
    CrossrefPubMedSuche in Google Scholar
  • 41 Sundaram S, Giri S, Binmoeller K. Lumen-apposing metal stents: a primer on indications and technical tips. Indian J Gastroenterol 2024;
    CrossrefPubMedSuche in Google Scholar
  • 42 Koduri KK, Jagtap N, Lakhtakia S. et al. Biflanged metal stents versus plastic stents in the endoscopic ultrasound-guided drainage of walled-off necrosis: a randomized controlled trial. Endoscopy 2024;
    Thieme ConnectPubMedSuche in Google Scholar
  • 43 Giri S, Harindranath S, Afzalpurkar S, Angadi S, Sundaram S. Does a coaxial double pigtail stent reduce adverse events after lumen apposing metal stent placement for pancreatic fluid collections? A systematic review and meta-analysis. Ther Adv Gastrointest Endosc 2023; 16: 26 317745231199364
    Suche in Google Scholar
  • 44 Bang JY, Hasan M, Navaneethan U, Hawes R, Varadarajulu S. Lumen-apposing metal stents (LAMS) for pancreatic fluid collection (PFC) drainage: may not be business as usual. Gut 2017; 66 (12) 2054-2056
    CrossrefPubMedSuche in Google Scholar
  • 45 House MG, Cameron JL, Schulick RD. et al. Incidence and outcome of biliary strictures after pancreaticoduodenectomy. Ann Surg 2006; 243 (05) 571-576 , discussion 576–578
    CrossrefPubMedSuche in Google Scholar
  • 46 Javed AA, Mirza MB, Sham JG. et al. Postoperative biliary anastomotic strictures after pancreaticoduodenectomy. HPB (Oxford) 2021; 23 (11) 1716-1721
    CrossrefPubMedSuche in Google Scholar
  • 47 Guo W, Ye X, Li J. et al. Comparison of surgical outcomes among open, laparoscopic, and robotic pancreatoduodenectomy: a single-center retrospective study. BMC Surg 2022; 22 (01) 348
    CrossrefPubMedSuche in Google Scholar
  • 48 Mucci-Hennekinne S, Brachet D, Clouston H, Pessaux P, Hamy A, Arnaud JP. Management of a stenotic pancreatico-digestive tract anastomosis following pancreatoduodenectomy. J Hepatobiliary Pancreat Surg 2007; 14 (05) 514-517
    CrossrefPubMedSuche in Google Scholar
  • 49 Amano H, Takada T, Ammori BJ. et al. Pancreatic duct patency after pancreaticogastrostomy: long-term follow-up study. Hepatogastroenterology 1998; 45 (24) 2382-2387
    PubMedSuche in Google Scholar
  • 50 Nennstiel S, Weber A, Frick G. et al. Drainage-related complications in percutaneous transhepatic biliary drainage: an analysis over 10 years. J Clin Gastroenterol 2015; 49 (09) 764-770
    CrossrefPubMedSuche in Google Scholar
  • 51 Skinner M, Popa D, Neumann H, Wilcox CM, Mönkemüller K. ERCP with the overtube-assisted enteroscopy technique: a systematic review. Endoscopy 2014; 46 (07) 560-572
    Thieme ConnectPubMedSuche in Google Scholar
  • 52 Pal P, Kulkarni SA, Chaudhari H. et al. Single-balloon enteroscopy—guided ERCP in surgically altered anatomy is safe and highly effective: results from a prospective study. J Dig Endosc 2019; 10 (04) 221-227
    Thieme ConnectSuche in Google Scholar
  • 53 Garcés-Durán R, Monino L, Deprez PH, Piessevaux H, Moreels TG. Endoscopic treatment of biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants: lessons learned from single-balloon enteroscopy-assisted ERCP. Hepatobiliary Pancreat Dis Int 2024; 23 (05) 509-514
    Suche in Google Scholar
  • 54 Krutsri C, Kida M, Yamauchi H, Iwai T, Imaizumi H, Koizumi W. Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy. World J Gastroenterol 2019; 25 (26) 3313-3333
    CrossrefPubMedSuche in Google Scholar
  • 55 Sundaram S, Kale A. Endoscopic ultrasound guided biliary drainage in surgically altered anatomy: a comprehensive review of various approaches. World J Gastrointest Endosc 2023; 15 (03) 122-132
    CrossrefPubMedSuche in Google Scholar
  • 56 Nakai Y, Kogure H, Isayama H, Koike K. Endoscopic ultrasound-guided biliary drainage for benign biliary diseases. Clin Endosc 2019; 52 (03) 212-219
    CrossrefPubMedSuche in Google Scholar
  • 57 Jovani M, Ichkhanian Y, Vosoughi K, Khashab MA. EUS-guided biliary drainage for postsurgical anatomy. Endosc Ultrasound 2019; 8 (Suppl. 01) S57-S66
    CrossrefPubMedSuche in Google Scholar
  • 58 Katanuma A, Hayashi T, Kin T. et al. Interventional endoscopic ultrasonography in patients with surgically altered anatomy: techniques and literature review. Dig Endosc 2020; 32 (02) 263-274
    CrossrefPubMedSuche in Google Scholar
  • 59 Dhir V, Artifon EL, Gupta K. et al. Multicenter study on endoscopic ultrasound-guided expandable biliary metal stent placement: choice of access route, direction of stent insertion, and drainage route. Dig Endosc 2014; 26 (03) 430-435
    CrossrefPubMedSuche in Google Scholar
  • 60 Khashab MA, Valeshabad AK, Modayil R. et al. EUS-guided biliary drainage by using a standardized approach for malignant biliary obstruction: rendezvous versus direct transluminal techniques (with videos). Gastrointest Endosc 2013; 78 (05) 734-741
    CrossrefPubMedSuche in Google Scholar
  • 61 Martin A, Kistler CA, Wrobel P, Yang JF, Siddiqui AA. Endoscopic ultrasound-guided pancreaticobiliary intervention in patients with surgically altered anatomy and inaccessible papillae: a review of current literature. Endosc Ultrasound 2016; 5 (03) 149-156
    CrossrefPubMedSuche in Google Scholar
  • 62 Iwashita T, Nakai Y, Hara K, Isayama H, Itoi T, Park DH. Endoscopic ultrasound-guided antegrade treatment of bile duct stone in patients with surgically altered anatomy: a multicenter retrospective cohort study. J Hepatobiliary Pancreat Sci 2016; 23 (04) 227-233
    CrossrefPubMedSuche in Google Scholar
  • 63 Khashab MA, El Zein MH, Sharzehi K. et al. EUS-guided biliary drainage or enteroscopy-assisted ERCP in patients with surgical anatomy and biliary obstruction: an international comparative study. Endosc Int Open 2016; 4 (12) E1322-E1327
    Thieme ConnectPubMedSuche in Google Scholar
  • 64 Jamwal KD, Sharma A, Padhan RK, Sharma MK. Outcomes of endoscopic biliary drainage in postsurgical anatomy using endoscopic ultrasound and enteroscopy: a comparative study. J Dig Endosc 2023; 14 (03) 127-134
    Thieme ConnectSuche in Google Scholar
  • 65 Siripun A, Sripongpun P, Ovartlarnporn B. Endoscopic ultrasound-guided biliary intervention in patients with surgically altered anatomy. World J Gastrointest Endosc 2015; 7 (03) 283-289
    CrossrefPubMedSuche in Google Scholar
  • 66 Minaga K, Takenaka M, Ogura T. et al. Endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction with surgically altered anatomy: a multicenter prospective registration study. Therap Adv Gastroenterol 2020; 13: 17 56284820930964
    CrossrefPubMedSuche in Google Scholar
  • 67 Shah JN, Marson F, Weilert F. et al. Single-operator, single-session EUS-guided anterograde cholangiopancreatography in failed ERCP or inaccessible papilla. Gastrointest Endosc 2012; 75 (01) 56-64
    CrossrefPubMedSuche in Google Scholar
  • 68 Tyberg A, Sharaiha RZ, Kedia P. et al. EUS-guided pancreatic drainage for pancreatic strictures after failed ERCP: a multicenter international collaborative study. Gastrointest Endosc 2017; 85 (01) 164-169
    CrossrefPubMedSuche in Google Scholar
  • 69 Kinney TP, Li R, Gupta K. et al. Therapeutic pancreatic endoscopy after Whipple resection requires rendezvous access. Endoscopy 2009; 41 (10) 898-901
    Thieme ConnectPubMedSuche in Google Scholar
  • 70 Chen YI, Levy MJ, Moreels TG. et al. An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery. Gastrointest Endosc 2017; 85 (01) 170-177
    CrossrefPubMedSuche in Google Scholar
  • 71 Kogure H, Sato T, Nakai Y. et al. Endoscopic management of pancreatic diseases in patients with surgically altered anatomy: clinical outcomes of combination of double-balloon endoscopy- and endoscopic ultrasound-guided interventions. Dig Endosc 2021; 33 (03) 441-450
    CrossrefPubMedSuche in Google Scholar
  • 72 Chandan S, Mohan BP, Khan SR. et al. Efficacy and safety of endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD): a systematic review and meta-analysis of 714 patients. Endosc Int Open 2020; 8 (11) E1664-E1672
    Thieme ConnectPubMedSuche in Google Scholar