Recurrent Pancreatic Fluid Collections in Disconnected Pancreatic Duct Without Permanent Indwelling Transmural...

The clinical profile and long-term outcomes of patients with walled-off necrosis (WON)and disconnected pancreatic duct (DPD) who lack permanent transmural plastic stents and go on to develop recurrent pancreatic fluid collection (PFCs) are not well established. We evaluated the long-term outcomes of patients with WON and DPD who did not have permanent or retained transmural plastic stents and subsequently developed recurrent PFCs.

Retrospective analysis of clinical characteristics and outcomes in patients with DPD without long-term transmural stents who developed recurrent PFC.

Seventeen patients (10.8%) (12 males; mean age: 36.7 ± 8.1 years) developed recurrence of PFC (mean size: 5.3 ± 1.4 cm) following successful resolution of ANC/WON after EUS-guided transmural drainage with LAMS (n = 8) or multiple plastic stents (n = 9). In 7 patients with recurrent PFC, no permanent transmural plastic stent could be placed, whereas in 10 patients, the transmural plastic stents migrated externally. Symptomatic recurrence was observed in 14 patients, whereas 3 patients developed asymptomatic recurrent PFCs. Patients with symptomatic recurrence of PFC were successfully treated with EUS-guided transmural drainage with single/multiple plastic stents.

Recurrent PFCs are frequently symptomatic in patients with DPD who lack permanent transmural stents, and these recurrences often require repeat therapeutic interventions, underscoring the importance of maintaining transmural tract patency.