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Related Experiment Videos

[External pancreatic fistulas management].

E V Stepan1, A S Ermolov1, M L Rogal'1

  • 1Sklifosovsky Research Institute of Emergency Care, Moscow.

Khirurgiia
|April 5, 2017
PubMed
Summary

Effective treatment of external postoperative pancreatic fistulas (EPF) involves conservative methods, octreotide, and endoscopic or surgical interventions. These approaches successfully closed fistulas in most patients, particularly those with unobstructed main pancreatic ducts.

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Area of Science:

  • Gastroenterology
  • Surgical Treatment
  • Pancreatic Diseases

Background:

  • External postoperative pancreatic fistulas (EPF) are a significant complication following pancreatic surgery.
  • Causes include pancreatic trauma, acute pancreatitis treatment, and pancreatic pseudocyst drainage.

Purpose of the Study:

  • To outline the primary treatment principles for external postoperative pancreatic fistulas.
  • To evaluate the efficacy of various conservative and interventional methods.

Main Methods:

  • Review of treatment principles for EPF.
  • Analysis of patient outcomes based on fistula cause and treatment modality.
  • Application of conservative management, octreotide administration, endoscopic papillotomy, pancreatic duct stenting, and surgical anastomosis.

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Main Results:

  • 93 patients recovered after treatment.
  • Complex conservative treatment closed fistulas in 74.2% of patients with normal main pancreatic duct (MPD) patency.
  • Octreotide, endoscopic papillotomy, and MPD stenting were key interventions.

Conclusions:

  • Conservative management is effective for EPF with normal MPD patency.
  • Endoscopic and surgical interventions are crucial for managing complex cases, including obstruction, stenosis, or failed conservative treatment.