RSS-Feed abonnieren
DOI: 10.1055/s-2006-925062
Endoscopic Management of Pancreaticopleural Fistulas: A Report of Three Patients
Publikationsverlauf
Submitted 12 April 2005
Accepted after revision 25 November 2005
Publikationsdatum:
23. März 2006 (online)
Pancreaticopleural fistulas are a rare complication of acute or chronic pancreatitis, and are usually treated by surgery. We report three patients whose pancreaticopleural fistulas were successfully treated by endoscopic retrograde cholangiopancreatography and drainage (stenting, nasopancreatic drainage). In one patient a pancreatic pseudocyst persisted despite successful initial closure of the leak using this method and, as it was also suspected to be infected, additional drainage of the pseudocyst was required. Endotherapy of pancreaticopleural fistulas could obviate the need for surgery when conventional medical treatment has failed in this condition.
References
- 1 Rockey D C, Cello J P. Pancreaticopleural fistula: report of 7 patients and review of the literature. Medicine. 1990; 69 332-344
- 2 Uchiyama T, Suzuki T, Adachi A. et al . Pancreatic pleural effusion: case report and review of 113 cases in Japan. Am J Gastroenterol. 1992; 87 387-391
- 3 Kaye M D. Pleuropulmonary complications of pancreatitis. Thorax. 1968; 23 297-306
- 4 Cameron J L. Chronic pancreatic ascites and pancreatic pleural effusions. Gastroenterology. 1978; 74 134-140
- 5 Pottmeyer E W, Frey C F, Matsuno S. Pancreaticopleural fistulas. Arch Surg. 1987; 122 648-654
- 6 Saeed Z A, Ramirez F C, Hepps K S. Endoscopic stent placement for internal and external pancreatic fistulas. Gastroenterology. 1993; 105 1213-1217
- 7 Garcia-Ricart F, Croizet O, EI Riwini M, Escourrou J. Endoscopic management of a persistent pancreatopleural fistula. Gastrointest Endosc. 1997; 46 359-361
- 8 Safadi B Y, Marks J M. Pancreatic-pleural fistula: the role of ERCP in diagnosis and treatment. Gastrointest Endosc. 2000; 51 213-215
- 9 Neher J R, Brady P G, Pinkas H, Ramos M. Pancreaticopleural fistula in chronic pancreatitis: resolution with endoscopic therapy. Gastrointest Endosc. 2000; 52 416-418
- 10 Miyachi A, Kikuyama M, Matsubayashi Y. et al . Successful treatment of pancreaticopleural fistula by nasopancreatic drainage and endoscopic removal of pancreatic duct calculi: a case report. Gastrointest Endosc. 2004; 59 454-457
- 11 Tajima Y, Fukuda K, Tsuneoka N. et al . Demonstration of a pancreaticopleural fistula with magnetic resonance cholangiopancreatography. Am J Surg. 2004; 187 741-742
- 12 Dhebri A R, Ferran N. Nonsurgical management of pancreaticopleural fistula. JOP. 2005; 6 152-161
- 13 Lipsett P A, Cameron J L. Internal pancreatic fistula. Am J Surg. 1992; 163 216-220
T. Koshitani, M.D.
Department of Gastroenterology
Kyoto City Hospital · 1-2 Higashitakada-cho Mibu Nakagyo-ku · Kyoto 604-8845 · Japan
Fax: +81-75-321-6025
eMail: tkoshi@hosp.city.kyoto.jp