国际肝胆胰疾病杂志(英文版)
國際肝膽胰疾病雜誌(英文版)
국제간담이질병잡지(영문판)
Hepatobiliary & Pancreatic Diseases International
2012年
2期
103-107
,共5页
pancreatic disease%pancreatitis%pancreatic pseudocyst
BACKGROUND:?Pancreaticopleural fistula (PPF) are uncommon. Complex multidisciplinary treatment is required due to nutritional compromise and sepsis. This is the first description of long-term follow-up of patients with PPF. <br> METHODS:?Eleven patients with PPF treated at a specialist unit were identified. Causation, investigation, treatment and outcomes were recorded. <br> RESULTS: Pancreatitis was the etiology of the PPF in 9 patients, and in the remaining 2 the PPF developed following distal pancreatectomy. Cross-sectional imaging demonstrated the site of duct disruption in 10 cases, with endoscopic retrograde cholangiopancreatography identifying the final case. Suppression of pancreatic exocrine secretion and percutaneous drainage formed the mainstay of treatment. Five cases resolved following pancreatic duct stent insertion and three patients required surgical treatment for established empyema. There were no complications. In all cases that resolved there has been no recurrence of PPF over a median follow-up of 50 months (range 15-62). <br> CONCLUSIONS:?PPF is an uncommon event complicating pancreatitis or pancreatectomy; pancreatic duct disruption is the common link. A step-up approach consisting of minimally invasive techniques treats the majority with surgery needed for refractory sepsis.