BACKGROUND: Data concerning the incidence and treatment of pancreatic fistula after necrosectomy in severe acute necrotizing pancreatitis (SAP) are scarce. Our aim was to assess the incidence of pancreatic fistula, and the feasibility and results of endoscopic transpapillary stenting (ETS) in patients with SAP after necrosectomy. METHODS: From January 2009 to December 2012 twenty-nine consecutive patients with SAP and necrosectomy in Oulu University Hospital were enrolled into this study. Five patients died before ETS because of the rapid progress of the disease and were, therefore, excluded. RESULTS: ERP was performed for the remaining 24 patients demonstrating fistula in 22/24 patients (92 %). ETS was successful in 23 patients and the fistula closed in all of them after a median of 82 (2-210) days with acceptable morbidity and no procedure-related mortality. CONCLUSION: All patients after necrosectomy for SAP seem to have internal or external pancreatic fistula. EST aimed at internal drainage of the necrosectomy cavity is a feasible and effective therapy in these patients.
BACKGROUND: Data concerning the incidence and treatment of pancreatic fistula after necrosectomy in severe acute necrotizing pancreatitis (SAP) are scarce. Our aim was to assess the incidence of pancreatic fistula, and the feasibility and results of endoscopic transpapillary stenting (ETS) in patients with SAP after necrosectomy. METHODS: From January 2009 to December 2012 twenty-nine consecutive patients with SAP and necrosectomy in Oulu University Hospital were enrolled into this study. Five patients died before ETS because of the rapid progress of the disease and were, therefore, excluded. RESULTS: ERP was performed for the remaining 24 patients demonstrating fistula in 22/24 patients (92 %). ETS was successful in 23 patients and the fistula closed in all of them after a median of 82 (2-210) days with acceptable morbidity and no procedure-related mortality. CONCLUSION: All patients after necrosectomy for SAP seem to have internal or external pancreatic fistula. EST aimed at internal drainage of the necrosectomy cavity is a feasible and effective therapy in these patients.
Authors: Hjalmar C van Santvoort; Marc G Besselink; Olaf J Bakker; H Sijbrand Hofker; Marja A Boermeester; Cornelis H Dejong; Harry van Goor; Alexander F Schaapherder; Casper H van Eijck; Thomas L Bollen; Bert van Ramshorst; Vincent B Nieuwenhuijs; Robin Timmer; Johan S Laméris; Philip M Kruyt; Eric R Manusama; Erwin van der Harst; George P van der Schelling; Tom Karsten; Eric J Hesselink; Cornelis J van Laarhoven; Camiel Rosman; Koop Bosscha; Ralph J de Wit; Alexander P Houdijk; Maarten S van Leeuwen; Erik Buskens; Hein G Gooszen Journal: N Engl J Med Date: 2010-04-22 Impact factor: 91.245
Authors: J Ruben Rodriguez; A Oswaldo Razo; Javier Targarona; Sarah P Thayer; David W Rattner; Andrew L Warshaw; Carlos Fernández-del Castillo Journal: Ann Surg Date: 2008-02 Impact factor: 12.969
Authors: Leandro Cardoso Barchi; Amir Zeide Charruf; Rodrigo José de Oliveira; Carlos Eduardo Jacob; Ivan Cecconello; Bruno Zilberstein Journal: Transl Gastroenterol Hepatol Date: 2016-12-27