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

Guido Costamagna, Alberto Leonardo Larghi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

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.
Lingua originaleEnglish
pagine (da-a)E273-E273
RivistaEndoscopy
Volume47 Suppl 1 UCTN
DOI
Stato di pubblicazionePubblicato - 2015

Keywords

  • endoscopic ultrasound guided drainage
  • fistula

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