Endoscopic Ultrasound-Guided Treatment of Pancreaticocutaneous Fistulas.
Pancreaticocutaneous fistulas (PCFs) may be refractory to medical therapy or endoscopic retrograde cholangopancreaticography. Four patients underwent endoscopic ultrasound-guided management of refractory PCFs, which were internalized by endoscopic ultrasound-guided transmural puncture of the pancreatic duct (n = 2), fistula tract (n = 1), or both (n = 1), with placement of transmural stents providing internal drainage to the stomach (n = 3) or duodenum (n = 1). Drainage from PCFs ceased in all patients, and all percutaneous drains were removed; internal stents were left in place indefinitely. Endoscopic ultrasound-guided interventions may successfully treat PCFs, allowing removal of percutaneous drains, and are an attractive alternative for patients who might otherwise require pancreatic resection.
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Abdul
A
Haseeb
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Barham K
BK
Abu Dayyeh
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Michael J
MJ
Levy
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Larissa L
LL
Fujii
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Randall K
RK
Pearson
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Suresh T
ST
Chari
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Ferga C
FC
Gleeson
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Bret T
BT
Peterson
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Santhi
S
Swaroop Vege
Division of Gastroenterology, Mayo Clinic, Rochester, MN.
Mark
M
Topazian