Endoscopic pancreatic duct stenting to treat pancreatic ascites

Bracher, G.Alan; Manocha, Anuj Paul; DeBanto, John R.; Gates, Lawrence K.; Slivka, Adam; Whitcomb, David C.; Bleau, Brian L.; Ulrich, Charles D.; Martin, Stephen P.

doi:10.1016/s0016-5107(99)70287-7

Cited by 90 publications

(62 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The disruption of the pancreatic duct results in the formation of internal fistula communicating with peritoneal or pleural cavities, which result in ascites or pleural effusion, respectively 5,16) . In most cases, IPF has been reported to develop secondary to alcoholic chronic pancreatitis [17][18][19][20][21] . In the present study, all patients presented pancreatic ascites or pleural effusion.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic transpapillary pancreatic stenting for internal pancreatic fistula with the disruption of the pancreatic ductal system

Tanaka¹,

Kuroki²,

Kitasato³

et al. 2013

Pancreatology

View full text Add to dashboard Cite

Abstract[Background]Internal pancreatic fistula (IPF) is a well-recognized complication of pancreatic diseases. Although there have been many reports concerning IPF, the therapy for IPF still remains controversial. We herein report our experiences with endoscopic transpapillary pancreatic stent therapy for IPF and evaluate its validity.[Method]Six patients with IPF who presented at our department and received endoscopic transpapillary pancreatic stent therapy were investigated, focusing on the clinical and imaging features as well as treatment strategies, the response to therapy and the outcome.[Results]All patients were complicated with stenosis or obstruction of the main pancreatic duct, and in these cases the pancreatic ductal disruption developed distal to the areas of pancreatic stricture. The sites of pancreatic ductal disruption were the pancreatic body in five patients and the pancreatic tail in one patient. All patients received endoscopic stent placement over the stenosis site of the pancreatic duct, and three patients improved completely and one patient improved temporarily. Finally, three patients underwent [Conclusion]Endoscopic transpapillary pancreatic stent therapy may be an appropriate first-line treatment to be considered before surgical treatment. The point of stenting for IPF is to place a stent over the stenosis site of the pancreatic duct to reduce the pancreatic ductal pressure and the pseudocyst's pressure.

show abstract

Section: Discussionmentioning

confidence: 99%

Endoscopic transpapillary pancreatic stenting for internal pancreatic fistula with the disruption of the pancreatic ductal system

Tanaka¹,

Kuroki²,

Kitasato³

et al. 2013

Pancreatology

View full text Add to dashboard Cite

show abstract

“…A pancreatic pseudocyst is usually the consequence of pancreatic destruction during acute, chronic pancreatitis or pancreatic blunt trauma (17,18,26). There is an important difference between pancreatic pseudocysts and postinflammatory fluid collection.…”

Section: Pancreatic Pseudocystsmentioning

confidence: 99%

“…Visualization of the fistulous tract is an indication of an internal pancreatic fistula (26). Both ERCP and magnetic resonance cholangiopancreatography (MRCP) are standard procedures to diagnose a pancreatic fistula (11,16,27).…”

Section: Visualizing Techniquesmentioning

confidence: 99%

Internal Pancreatic Fistulae - Management Review

Hać¹,

Śledziński²

2008

Polish Journal of Surgery

View full text Add to dashboard Cite

“…Three major series included 39 patients presenting with a pancreatic fistula after acute pancreatitis (n = 19) and associated with CP (n = 12) [55,66,67] . Treatment consisted in a trans-papillary drainage of pancreatic duct in 34 cases, associated with a transmural drainage of a cyst in four cases.…”

Section: Endoscopic Treatment Of Pancreatic Fistulasmentioning

confidence: 99%

Endoscopic treatment of chronic pancreatitis

Heyries¹,

Sahel²

2007

WJG

View full text Add to dashboard Cite

Treatment of chronic pancreatitis has been exclusively surgical for a long time. Recently, endoscopic therapy has become widely used as a primary therapeutic option. Initially performed for drainage of pancreatic cysts and pseudocysts, endoscopic treatments were adapted to biliary and pancreatic ducts stenosis. Pancreatic sphincterotomy which allows access to pancreatic ducts was firstly reported. Secondly, endoscopic methods of stenting, dilatation, and stones extraction of the bile ducts were applied to pancreatic ducts. Nevertheless, n e w i m p r o v e m e n t s w e r e n e c e s s a r y : f a i l u r e s o f pancreatic stone extraction justified the development of extra-corporeal shock wave lithotripsy; dilatation of pancreatic stenosis was improved by forage with a new device; moreover endosonography allowed guidance for celiac block, gastro-cystostomy, duodeno-cystostomy and pancreatico-gastrostomy. Although endoscopic treatments are more and more frequently accepted, indications are still debated. METHODSEndoscopic treatment needs a team (operator, anaesthesiologist) aware with Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures. Specific material is necessary: good fluoroscopy with the possibility to magnify pictures, and a duodenoscope with a 4.2 channel allowing insertion of high calibre stent (10 Fr). Moreover, a wide variety of endoscopic ancillar y instruments is essential: metallic and hydrophilic guidewire, sphincterotomes, Dormia basket, balloon dilatators and bougie dilatators (5-11.5 Fr), but also very thin guide wire (0.025 inches), fine-tipped sphincterotomes, Soehendra extractors (cf infra) [1] . Impaction of stones in pancreatic ducts needs the use of extracorporeal shock wave lithotripsy before endoscopic stone extraction [2]

show abstract

Endoscopic pancreatic duct stenting to treat pancreatic ascites

Cited by 90 publications

References 15 publications

Endoscopic transpapillary pancreatic stenting for internal pancreatic fistula with the disruption of the pancreatic ductal system

Endoscopic transpapillary pancreatic stenting for internal pancreatic fistula with the disruption of the pancreatic ductal system

Internal Pancreatic Fistulae - Management Review

Endoscopic treatment of chronic pancreatitis

Contact Info

Product

Resources

About