title: Endoscopic transpapillary nasopancreatic drainage alone to treat pancreatic ascites and pleural effusion.
abstract: BACKGROUND
  Pancreatic ascites and pleural effusion are uncommon sequelae of pancreatitis and are associated with significant morbidity and mortality. Endoscopic decompression of the pancreatic duct through transpapillary stent or nasopancreatic drain (NPD) has shown encouraging results but the experience is limited. The aim of the present study was to evaluate the efficacy of endoscopic transpapillary nasopancreatic drainage in patients with pancreatic ascites and pleural effusion.
  
  
  METHODS
  Over a period of 9 years, 10 patients (eight male) with pancreatic ascites and/or pleural effusion with pancreatic duct disruption documented on pancreatogram were studied. After informed consent, endoscopic transpapillary NPD was placed. The end-points were resolution of ascites and/or pleural effusion or need for surgery.
  
  
  RESULTS
  Of 10 patients (age range: 13 months-46 years), four patients had only ascites, four had only pleural effusion and two had both ascites and pleural effusion. Ascites and/or pleural effusion resolved in all the patients within 4 weeks of placement of NPD. The healing of ductal disruption was demonstrated by nasopancreatogram as early as 2 weeks and NPD could be removed without necessitating another endoscopy. No major complications related to NPD placement were noted. There was no recurrence of pancreatic ascites and/or pleural effusion at a mean follow up of 39 months.
  
  
  CONCLUSIONS
  Pancreatic ascites and pleural effusion can be effectively treated by endoscopic retrograde pancreatography and transpapillary NPD placement.
authors.affiliation: Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160023, India.
authors.forename: Deepak Kumar
authors.initials: DK
authors.lastname: Bhasin
authors.forename: Surinder Singh
authors.initials: SS
authors.lastname: Rana
authors.forename: Ismail
authors.initials: I
authors.lastname: Siyad
authors.forename: Ujjal
authors.initials: U
authors.lastname: Poddar
authors.forename: Babu Ram
authors.initials: BR
authors.lastname: Thapa
authors.forename: Saroj Kant
authors.initials: SK
authors.lastname: Sinha
authors.forename: Birinder
authors.initials: B
authors.lastname: Nagi
mesh_terms: D000293:Adolescent; D000328:Adult; D001201:Ascites / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000601:surgery*; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed