A case of late-onset postoperative pancreatic pleural effusion after laparoscopic distal pancreatectomy

概要

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A woman in her sixties was admitted to our hospital due to general fatigue and appetite loss occurring 84 days after laparoscopic distal pancreatectomy for autoimmune hemolytic anemia and cystic tumor of the pancreatic tail. During her hospitalization, bilateral pleural effusion suddenly developed and a chest tube insertion was performed. A high level of amylase in the pleural effusion suggested the possibility of pancreatic fistula. Endoscopic retrograde pancreatography showed disruption of the main pancreatic duct at the pancreatic body and pancreaticopleural fistula. Pancreatic pleural effusion was treated with the placement of an endoscopic nasopancreatic drainage tube, fasting, and administration of octreotide acetate and the patient recovered successfully with these conservative managements. Late-onset pleural effusions after distal pancreatectomy are rarely reported, however, it is important for clinicians to bear in mind that pancreatic pleural effusion could develop long after pancreatectomy in the patients with complicated disease.
日本膵臓学会の論文