INVESTIGATION OF ENDOSCOPIC PANCREATIC STENTING FOR PANCREATIC DUCT DISRUPTION

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To investigate the efficacy of transpapillary endoscopic pancreatic stenting (EPS) for various diseases caused by pancreatic duct rupture and to evaluate accidental events. Subjects were comprised of 10 patients (7 men, 3 women) who underwent EPS at Showa University Fujigaoka Hospital over a 6-year period, from January 2002 to May 2008. Mean subject age was 55.8 years. EPS was performed for pancreatic pseudocyst (n=6), pancreatic pleural effusion (n=2), pancreatic ascites (postoperative internal pancreatic fistula, n=1) and pancreatic duct damage (n=1) . (1) A stent was placed in the cyst in 3 of the 6 patients with pancreatic pseudocysts, and in the pancreatic duct proximal to the cyst for the other 3 patients. With regard to therapeutic results, the pseudocyst disappeared in 2 patients with the stent placed inside the cyst and in a patient with the stent placed in the pancreatic duct. However, pancreatic cysts did not disappear in the remaining patients, so a drainage tube was placed through other routes. (2) In the 2 patients with pancreatic pleural effusion, effusion disappeared using a stent in the pancreatic duct proximal to the pancreatic duct stenosis in one patient and in the pancreatic duct distal to pancreatic duct rupture in the other patient. (3) In the patient with pancreatic ascites, ascites disappeared after a stent was placed in the residual pancreatic duct. (4) In the patient with pancreatic duct damage, a stent was placed in the pancreatic duct distal to duct rupture preventing extrapancreatic flow of pancreatic juice. Regarding complications, post-EPS infection developed in 3 patients. EPS is safe and effective therapy for pancreatic duct disruption.

INVESTIGATION OF ENDOSCOPIC PANCREATIC STENTING FOR PANCREATIC DUCT DISRUPTION

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