Abstract:
:Pancreaticopleural fistulas are a rare complication of pancreatitis. We report two cases from our institution and review 37 cases of pancreaticopleural fistulas identified in the literature. Endoscopic retrograde cholangiopancreatography was more sensitive compared to computed tomography in demonstrating pancreaticopleural fistulas (79% versus 43%, respectively). Medical therapy with total parenteral nutrition, octreotide, and/or chest tube placement was successful in resolving the pancreaticopleural fistula in up to 33% of cases. None of the patients who underwent pancreatic duct stent and/or nasopancreatic drain placement required surgical intervention. Endoscopic retrograde cholangiopancreatography is the initial test of choice when the diagnosis of pancreaticopleural fistula is suspected. Early endoscopic intervention with pancreatic duct stent placement is recommended given its high success rate in fistula closure. Medical therapies are useful adjuncts to endoscopic therapy, but rarely result in pancreaticopleural fistula closure alone. Surgical interventions should only be considered after failure of endoscopic and medical therapies.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Oh YS,Edmundowicz SA,Jonnalagadda SS,Azar RRdoi
10.1007/s10620-006-3073-7subject
Has Abstractpub_date
2006-01-01 00:00:00pages
1-6issue
1eissn
0163-2116issn
1573-2568journal_volume
51pub_type
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journal_title:Digestive diseases and sciences
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