Endoscopic therapy for main pancreatic-duct rupture after Silastic-ring vertical gastroplasty.
BACKGROUND
Acute pancreatitis with pancreatic-duct rupture and fluid collections is a rare complication after Silastic ring vertical gastroplasty. It can be attributed to pancreatic trauma occurring during surgery.


METHODS
Endoscopic therapy with transmural drainage of collections was performed in 4 patients who had undergone Silastic ring vertical gastroplasty and who had presented with acute pancreatitis with main pancreatic-duct rupture at the body of the pancreas.


METHODS
All patients had successful transmural drainage with cystogastrostomy, followed by stent insertion. Only one patient had a late recurrence because of stent migration. The major difficulty was related to positioning of the endoscope and the possible need of pneumatic dilation of the outlet channel to reach the puncture site.


CONCLUSIONS
Endoscopic therapy is useful in acute pancreatitis with pancreatic-duct rupture after Silastic-ring vertical gastroplasty and, although technically difficult, could be considered as a first-line approach in the management of these patients.
Medical Department of Gastroenterology, Erasme University Hospital, 1070 Brussels, Belgium.
Marianna
M
Arvanitakis
Myriam
M
Delhaye
Reza
R
Chamlou
Celso
C
Matos
Jean
J
Closset
Abdellilah
A
Medhi
Michel
M
Baize
Olivier
O
Le Moine
Jacques
J
Deviere
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000295:instrumentation; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D010183:Pancreatic Ducts; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery*; D019919:Prosthesis Implantation / Q000295:instrumentation; D012086:Reoperation; D012422:Rupture, Spontaneous / Q000150:complications / Q000601:surgery; D012826:Silicone Elastomers; D015607:Stents
D012826:Silicone Elastomers; C078083:silastic medical adhesive type A