title: Laparoscopy assisted transjejunal ERCP for treatment of pancreaticopleural fistula.
abstract: BACKGROUND
  Pancreaticopleural fistula is a rare complication estimated to occur in 0.5% of the patients with pancreatitis and even extremely rare in surgically altered anatomy (e.g. Roux-en-Y anastomosis) patients. The conventional ERCP is difficult to treat pancreaticopleural fistula in a patient with complex upper GI anatomy because of long anatomical route.
  
  
  METHODS
  We represent a case of a 47-year-old female with remote subtotal gastrectomy with Roux-en-Y gastrojejunostomy admitted with recurrent left pleural effusion due to pancreaticopleural fistula. After failed ERCP through the anatomical route, pancreaticopleural fistula was treated successfully with laparoscopy-assisted transjejunal ERCP.
  
  
  CONCLUSIONS
  Laparoscopy-assisted ERCP is a useful modality in patients with surgically altered anatomy.
authors.affiliation: Division of GI and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Atif
authors.initials: A
authors.lastname: Saleem
authors.forename: Mark D
authors.initials: MD
authors.lastname: Sawyer
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000000981:diagnostic imaging / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D010995:Pleural Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D016156:Respiratory Tract Fistula / Q000000981:diagnostic imaging / Q000601:surgery*