Permanent Indwelling Transmural Stents for Endoscopic Treatment of Patients With Disconnected Pancreatic Duct Syndrome: Long-term Results.
BACKGROUND
Disconnected pancreatic duct syndrome (DPDS) is defined as the complete disruption of the main pancreatic duct, the result are peripancreatic fluid collections or pancreatic leaks. The aim of this study was to report the results of derivative endoscopic treatment of DPDS in a long-term follow-up period.


METHODS
We performed a retrospective analysis of prospectively collected data. Endoscopic treatment consisted of transmural drainage with 2 double pigtail plastic stents (7 F and 4 cm) deployed under endoscopic ultrasound guidance.


RESULTS
In total, 21 patients were included in our study. There were 15 (71%) men and the median age was 36 years (range, 23 to 86 y). The principal etiology of DPDS was acute pancreatitis. A total of 20 (95.2%) patients were diagnosed with DPDS by endoscopic pancreatography and only 1 (4.8%) patient by magnetic resonance cholangiopancreatography (MRCP). The median follow-up time was 28 months (range, 7 to 76 mo). Technique success was 100% and initial clinical success was 80.9% (17/21). Three (17.6%) of these patients required a new endoscopic procedure with success in all cases. During follow-up, 11 (52%) patients developed diabetes mellitus and 3 patients (14%) developed exocrine pancreatic insufficiency. There were 5 (15%) patients with complications.


CONCLUSIONS
According to our data, endoscopic treatment with the placement of a permanent indwelling transmural stents is a useful and safe tool for the treatment of DPDS.
National Institute Medical Sciences and Nutrition Salvador Zubiran.
Felix I
FI
Téllez-Aviña
National Institute Medical Sciences and Nutrition Salvador Zubiran.
Luis E
LE
Casasola-Sánchez
National Institute Medical Sciences and Nutrition Salvador Zubiran.
Miguel Á
MÁ
Ramírez-Luna
National Institute Medical Sciences and Nutrition Salvador Zubiran.
Ángela
Á
Saúl
National Institute Medical Sciences and Nutrition Salvador Zubiran.
Enrique
E
Murcio-Pérez
Pancreas Clinic, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
Carlos
C
Chan
Pancreas Clinic, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
Luis
L
Uscanga
National Institute Medical Sciences and Nutrition Salvador Zubiran.
Gilberto
G
Duarte-Medrano
National Institute Medical Sciences and Nutrition Salvador Zubiran.
Francisco
F
Valdovinos-Andraca
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery; D019283:Pancreatitis, Acute Necrotizing / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult