A minimally invasive approach for postoperative pancreatic fistula

• Published in: Cardiovascular and interventional radiology Vol. 26; no. 6; pp. 580 - 582
• Main Authors: YAMAZAKI, Shintaro, KURAMOTO, Kenmei, ITOH, Yutaka, WATANABE, Yoshika, UEDA, Toshisada
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.11.2003; Berlin Springer Nature B.V
• Subjects: Aged; Biological and medical sciences; Cardiology. Vascular system; DISEASE INCIDENCE; DRAINAGE; Drainage - methods; DUCTS; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Minimally Invasive Surgical Procedures - methods; PANCREAS; Pancreatic Fistula - diagnostic imaging; Pancreatic Fistula - etiology; Pancreatic Fistula - surgery; Pancreaticoduodenectomy - adverse effects; Radiography, Interventional - methods; RADIOLOGY AND NUCLEAR MEDICINE; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); THERAPY; Treatment Outcome; Postoperative; Nuclear medicine; Minimally invasive surgery; Minimally invasive radiology-Pancreatic fistula-Pancreaticoduodenectomy; Surgical approach; Fistula; Circulatory system; Cardiology; Pancreas
• DOI: 10.1007/s00270-003-0086-x
• ISSN: 0174-1551

Pancreas fistula is a well-known and severe complication of pancreaticoduodenectomy. It is difficult to control with conservative therapy, inducing further complications and severe morbidity. Until now, re-operation has been the only way to resolve pancreatic fistula causing complete dehiscence of the pancreatic-enteric anastomosis (complete pancreatic fistula). Percutaneous transgastric fistula drainage is one of the treatments for pancreatic fistula. This procedure allows both pancreas juice drainage and anastomosis re-construction at the same time. This is effective and minimally invasive but difficult to adapt to a long or complicated fistula. In particular, dilatation of the main pancreatic duct is indispensable. This paper reports the successful resolution of a postoperative pancreatic fistula by a two-way-approach percutaneous transgastric fistula drainage procedure. Using a snare catheter from the fistula and a flexible guidewire from the transgastric puncture needle, it can be performed either with or without main pancreatic duct dilatation.