title: The endoscopic management of pancreatic fistulas.
abstract: BACKGROUND
  Interest in the use of therapeutic endoscopy for the treatment of pancreatic diseases has been on the increase for several years. Our aim was to assess the efficacy of endoscopic retrograde cholangiopancreaticography (ERCP) in the treatment of pancreatic fistulas.
  
  
  METHODS
  We evaluated the results of therapeutic ERCP in 50 patients with pancreatic fistula treated at the Helsinki University Central Hospital from 1998 to 2003.
  
  
  RESULTS
  The success rate of fistula closure after therapeutic ERCP was 82%. Five patients required operative treatment when ERCP was unsuccessful. There was little morbidity and no procedure-related mortality. Four patients died because severe illnesses made them unfit for any further procedures.
  
  
  CONCLUSIONS
  ERCP is a safe and effective modality and should be considered as first-line therapy in the management of pancreatic fistula.
authors.affiliation: Department of Gastrointestinal and General Surgery, Helsinki University Central Hospital, Helsinki, Finland. jorma.halttunen@hus.fi
authors.forename: J
authors.initials: J
authors.lastname: Halttunen
authors.forename: L
authors.initials: L
authors.lastname: Weckman
authors.forename: E
authors.initials: E
authors.lastname: Kemppainen
authors.forename: M L
authors.initials: ML
authors.lastname: Kylänpää
mesh_terms: D034841:Abdominal Cavity / Q000601:surgery; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods* / Q000706:statistics & numerical data; D002908:Chronic Disease; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis / Q000601:surgery; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities; D010183:Pancreatic Ducts / Q000473:pathology; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000601:surgery*; D010195:Pancreatitis / Q000150:complications; D010995:Pleural Diseases / Q000175:diagnosis / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome