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• W2014156263 abstract "Pancreatic duct leak (PL) is a complication of acute or chronic pancreatitis or pancreatic trauma. Surgical therapy(Rx) has been the traditional Rx for PLs that fail to resolve with medical Rx. Recent reports support a role for endoscopic therapy (ERx). We report the result of ERx in pts with PL. Methods: From 4/94 to 10/99, 153 pts (91 men, 62 women) mean age 51 yrs (range 9-89) were found to have PL at ERP. According to ERP finding, pts were categorized as 1) complete pancreatic duct disruptions (CPDD)-Main PD disruption without visualization or wire passage into upstream duct 2) partial main pancreatic duct disruption (PPDD)- Main PD visualized upstream from PL and 3)small duct leak (SD)-Leak from side branch. ERx included endoscopic sphincterotomy (ES), pancreatic duct stricture dilation if needed, and pancreatic stent or nasopancreatic catheter (NPC) placement. Pts with an associated accessible pseudocyst had endoscopic drainage by a transpapillary, transmural, or combined approach. Longterm follow-up was obtained by CT, ERP, clinical evaluation, and phone calls. Results: See table. Summary: 1) ERx of PL was successful in 102/121 (84%) pts with a recurrence rate of 4%. 2) pts with PPDD (98%) or SD (100%) were more likely to seal than pts with complete disruptions (62%, p <0.03). Conclusion: ERx appears to be a useful alternate to surgery in pts with PPDD and SD that fail to resolve with medical therapy. Further delineation of treatment criteria are needed in CPDD pts so as to select ERx only for pts who are likely to seal their PL. Pancreatic duct leak (PL) is a complication of acute or chronic pancreatitis or pancreatic trauma. Surgical therapy(Rx) has been the traditional Rx for PLs that fail to resolve with medical Rx. Recent reports support a role for endoscopic therapy (ERx). We report the result of ERx in pts with PL. Methods: From 4/94 to 10/99, 153 pts (91 men, 62 women) mean age 51 yrs (range 9-89) were found to have PL at ERP. According to ERP finding, pts were categorized as 1) complete pancreatic duct disruptions (CPDD)-Main PD disruption without visualization or wire passage into upstream duct 2) partial main pancreatic duct disruption (PPDD)- Main PD visualized upstream from PL and 3)small duct leak (SD)-Leak from side branch. ERx included endoscopic sphincterotomy (ES), pancreatic duct stricture dilation if needed, and pancreatic stent or nasopancreatic catheter (NPC) placement. Pts with an associated accessible pseudocyst had endoscopic drainage by a transpapillary, transmural, or combined approach. Longterm follow-up was obtained by CT, ERP, clinical evaluation, and phone calls. Results: See table. Summary: 1) ERx of PL was successful in 102/121 (84%) pts with a recurrence rate of 4%. 2) pts with PPDD (98%) or SD (100%) were more likely to seal than pts with complete disruptions (62%, p <0.03). Conclusion: ERx appears to be a useful alternate to surgery in pts with PPDD and SD that fail to resolve with medical therapy. Further delineation of treatment criteria are needed in CPDD pts so as to select ERx only for pts who are likely to seal their PL." @default.
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• W2014156263 date "2000-04-01" @default.
• W2014156263 modified "2023-10-16" @default.
• W2014156263 title "3802 Pancreatic duct leaks: results of endoscopic management." @default.
• W2014156263 doi "https://doi.org/10.1016/s0016-5107(00)14301-9" @default.
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