Effective Endoscopic Ultrasound-Guided Transgastric Drainage in a Case of Subcutaneous Intractable Postoperative Pancreatic Fistula
We report a case with postoperative pancreatic fistula successfully treated by endoscopic transgastric drainage. A 79-year-old man with cancer of the head of the pancreas underwent subtotal stomach-preserving pancreatoduodenectomy. On postoperative day 9, based on a high amylase level in drainage fl...
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| Published in | Nippon Shokaki Geka Gakkai zasshi Vol. 45; no. 2; pp. 197 - 202 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society of Gastroenterological Surgery
2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9768 1348-9372 1348-9372 |
| DOI | 10.5833/jjgs.45.197 |
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| Abstract | We report a case with postoperative pancreatic fistula successfully treated by endoscopic transgastric drainage. A 79-year-old man with cancer of the head of the pancreas underwent subtotal stomach-preserving pancreatoduodenectomy. On postoperative day 9, based on a high amylase level in drainage fluid, we suspected postoperative pancreatic fistula. The drainage tube was withdrawn on the 26th postoperative day after confirming closure of the fistula. He complained of upper abdominal pain and fever on the 36th postoperative day. CT scan revealed an abdominal fluid collection 2.5 cm in diameter around the pancreatojejunostomy. As percutaneous drainage was abandoned due to the presence of the small bowel between the abdominal wall and the lesion, endoscopic ultrasound (EUS)-guided transgastric drainage was attempted. Immediately after the procedure, the patient recovered and became asymptomatic. Since EUS-guided transgastric drainage for postoperative pancreatic fistula appears to be safe and feasible, it is an option for selected patients. |
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| AbstractList | We report a case with postoperative pancreatic fistula successfully treated by endoscopic transgastric drainage. A 79-year-old man with cancer of the head of the pancreas underwent subtotal stomach-preserving pancreatoduodenectomy. On postoperative day 9, based on a high amylase level in drainage fluid, we suspected postoperative pancreatic fistula. The drainage tube was withdrawn on the 26th postoperative day after confirming closure of the fistula. He complained of upper abdominal pain and fever on the 36th postoperative day. CT scan revealed an abdominal fluid collection 2.5 cm in diameter around the pancreatojejunostomy. As percutaneous drainage was abandoned due to the presence of the small bowel between the abdominal wall and the lesion, endoscopic ultrasound (EUS)-guided transgastric drainage was attempted. Immediately after the procedure, the patient recovered and became asymptomatic. Since EUS-guided transgastric drainage for postoperative pancreatic fistula appears to be safe and feasible, it is an option for selected patients. |
| Author | Hurukawa, Shotaro Tanaka, Eiichi Tsuchikawa, Takahiro Kondo, Satoshi Matsumoto, Joe Hirano, Satoshi Nasu, Yuya Kato, Kentaro Yamamoto, Kazuyuki Shichinohe, Toshiaki |
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| Cites_doi | 10.1016/S0016-5107(03)02878-5 10.1111/j.1572-0241.2006.01014.x 10.1067/S0016-5107(03)01966-7 10.2958/suizo.23.105 10.1016/S0016-5107(04)01310-0 10.1016/S0016-5107(92)70384-8 10.1055/s-2003-39673 10.1016/S0016-5107(92)70385-X 10.1016/S0016-5107(05)00541-9 10.1016/j.bpg.2004.06.027 10.1016/S0016-5107(96)70047-0 10.1055/s-2001-13695 10.1016/S0016-5085(97)70164-1 10.1055/s-2003-37268 10.5833/jjgs.44.347 10.1136/gut.44.5.720 |
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| References | 5) Giovannini M, Bories E, Moutardier V, Pesenti C, Guillemin A, Lelong B, et al. Drainage of deep pelvic abscesses using therapeutic echo endoscopy. Endoscopy. 2003 Jun;35(6):511-4. 13) Costamagna G, Mutignani M, Ingrosso M, Vamvakousis V, Alevras P, Manta R, et al. Endoscopic Treatment of Postsurgical External Pancreatic Fistulas. Endoscopy. 2001 Apr;33(4):317-22. 17) Arvanitakis M, Delhaye M, Bali MA, Matos C, Le Moine O, Devière J. Endoscopic treatment of external pancreatic fistulas: when draining the main pancreatic duct is not enough. Am J Gastroenterol. 2007 Mar;102(3):516-24. 4) 江川新一，当間宏樹，大東弘明，奥坂拓志，中尾昭公，羽鳥 隆，ほか．膵癌登録報告2007ダイジェスト．膵臓．2008;23(2):105-23. 2) Grimm H, Binmoeller KF, Soehendra N. Endosonography-guided drainage of a pancreatic pseudocyst. Gastrointest Endosc. 1992 Mar-Apr;38(2):170-1. 9) Seewald S, Groth S, Omar S, Imazu H, Seitz U, de Weerth A, et al. Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess: a new safe and effective treatment algorithm (videos). Gastrointest Endosc. 2005 Jul;62(1):92-100. 14) Le Moine O, Matos C, Closset J, Devière J. Endoscopic management of pancreatic fistula after pancreatic and other abdominal surgery. Best Pract Res Clin Gastroenterol. 2004 Oct;18(5):957-75. 15) Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wiersema LM. Endosonography-guided fine needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997 Apr;112(4):1087-95. 7) Seewald S, Brand B, Omar S, Yasuda I, Seitz U, Mendoza G, et al. EUS-guided drainage of subphrenic abscess. Gastrointest Endosc. 2004 Apr;59(4):578-80. 8) Attwell AR, McIntyre RC, Antillon MR, Chen YK. EUS-guided drainage of a diverticular abscess as an adjunct to surgical therapy. Gastrointest Endosc. 2003 Oct;58(4):612-6. 3) Wiersema MJ, Wiersema LM. Endosonography-guided celiac plexus neurolysis. Gastrointest Endosc. 1996 Dec;44(6):656-62. 12) 林 裕之，富田剛治，宮永太門，服部昌和，道伝研司，細川 治，ほか．術後膵液瘻に対するステント留置 膵体尾部切除後の術後膵液瘻に対する内視鏡的内瘻術の経験．消化器内視鏡．2007;19(12):1731-5. 11) Giovannini M, Binmoeller K, Seifert H. Endoscopic Ultrasound-Guided Cystogastrostomy. Endoscopy. 2003 Mar;35(3):239-45. 6) Kahaleh M, Yoshida C, Kane L, Yeaton P. EUS drainage of a mediastinal abscess. Gastrointest Endosc. 2004 Jul;60(1):158-60. 16) Williams DB, Sahai AV, Aabakken L, Penman ID, van Velse A, Webb J, et al. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut. 1999 May;44(5):720-6. 10) 竹林克士，橋本雅司，春田周宇介，江原一尚，今村網男，上野正紀，ほか．術後膵液瘻に対する内視鏡的経胃ドレナージが奏効した2症例．日本消化器外科学会雑誌．2011;44(3):347-52. 1) Vilmann P, Jacobsen GK, Henriksen FW, Hancke S. Endoscopic ultrasonography with guided fine needle aspiration biopsy in pancreatic desease. Gastrointest Endosc. 1992 Mar-Apr;38(2):172-3. 11 13 14 15 16 17 HAYASHI HIROYUKI (12) 2007; 19 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 8) Attwell AR, McIntyre RC, Antillon MR, Chen YK. EUS-guided drainage of a diverticular abscess as an adjunct to surgical therapy. Gastrointest Endosc. 2003 Oct;58(4):612-6. – reference: 14) Le Moine O, Matos C, Closset J, Devière J. Endoscopic management of pancreatic fistula after pancreatic and other abdominal surgery. Best Pract Res Clin Gastroenterol. 2004 Oct;18(5):957-75. – reference: 7) Seewald S, Brand B, Omar S, Yasuda I, Seitz U, Mendoza G, et al. EUS-guided drainage of subphrenic abscess. Gastrointest Endosc. 2004 Apr;59(4):578-80. – reference: 6) Kahaleh M, Yoshida C, Kane L, Yeaton P. EUS drainage of a mediastinal abscess. Gastrointest Endosc. 2004 Jul;60(1):158-60. – reference: 11) Giovannini M, Binmoeller K, Seifert H. Endoscopic Ultrasound-Guided Cystogastrostomy. Endoscopy. 2003 Mar;35(3):239-45. – reference: 12) 林 裕之，富田剛治，宮永太門，服部昌和，道伝研司，細川 治，ほか．術後膵液瘻に対するステント留置 膵体尾部切除後の術後膵液瘻に対する内視鏡的内瘻術の経験．消化器内視鏡．2007;19(12):1731-5. – reference: 15) Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wiersema LM. Endosonography-guided fine needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997 Apr;112(4):1087-95. – reference: 9) Seewald S, Groth S, Omar S, Imazu H, Seitz U, de Weerth A, et al. Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess: a new safe and effective treatment algorithm (videos). Gastrointest Endosc. 2005 Jul;62(1):92-100. – reference: 16) Williams DB, Sahai AV, Aabakken L, Penman ID, van Velse A, Webb J, et al. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut. 1999 May;44(5):720-6. – reference: 10) 竹林克士，橋本雅司，春田周宇介，江原一尚，今村網男，上野正紀，ほか．術後膵液瘻に対する内視鏡的経胃ドレナージが奏効した2症例．日本消化器外科学会雑誌．2011;44(3):347-52. – reference: 17) Arvanitakis M, Delhaye M, Bali MA, Matos C, Le Moine O, Devière J. Endoscopic treatment of external pancreatic fistulas: when draining the main pancreatic duct is not enough. Am J Gastroenterol. 2007 Mar;102(3):516-24. – reference: 1) Vilmann P, Jacobsen GK, Henriksen FW, Hancke S. Endoscopic ultrasonography with guided fine needle aspiration biopsy in pancreatic desease. Gastrointest Endosc. 1992 Mar-Apr;38(2):172-3. – reference: 3) Wiersema MJ, Wiersema LM. Endosonography-guided celiac plexus neurolysis. Gastrointest Endosc. 1996 Dec;44(6):656-62. – reference: 5) Giovannini M, Bories E, Moutardier V, Pesenti C, Guillemin A, Lelong B, et al. Drainage of deep pelvic abscesses using therapeutic echo endoscopy. Endoscopy. 2003 Jun;35(6):511-4. – reference: 2) Grimm H, Binmoeller KF, Soehendra N. Endosonography-guided drainage of a pancreatic pseudocyst. Gastrointest Endosc. 1992 Mar-Apr;38(2):170-1. – reference: 4) 江川新一，当間宏樹，大東弘明，奥坂拓志，中尾昭公，羽鳥 隆，ほか．膵癌登録報告2007ダイジェスト．膵臓．2008;23(2):105-23. – reference: 13) Costamagna G, Mutignani M, Ingrosso M, Vamvakousis V, Alevras P, Manta R, et al. Endoscopic Treatment of Postsurgical External Pancreatic Fistulas. Endoscopy. 2001 Apr;33(4):317-22. – ident: 7 doi: 10.1016/S0016-5107(03)02878-5 – volume: 19 start-page: 1731 issn: 0915-3217 issue: 12 year: 2007 ident: 12 – ident: 17 doi: 10.1111/j.1572-0241.2006.01014.x – ident: 8 doi: 10.1067/S0016-5107(03)01966-7 – ident: 4 doi: 10.2958/suizo.23.105 – ident: 6 doi: 10.1016/S0016-5107(04)01310-0 – ident: 2 doi: 10.1016/S0016-5107(92)70384-8 – ident: 5 doi: 10.1055/s-2003-39673 – ident: 1 doi: 10.1016/S0016-5107(92)70385-X – ident: 9 doi: 10.1016/S0016-5107(05)00541-9 – ident: 14 doi: 10.1016/j.bpg.2004.06.027 – ident: 3 doi: 10.1016/S0016-5107(96)70047-0 – ident: 13 doi: 10.1055/s-2001-13695 – ident: 15 doi: 10.1016/S0016-5085(97)70164-1 – ident: 11 doi: 10.1055/s-2003-37268 – ident: 10 doi: 10.5833/jjgs.44.347 – ident: 16 doi: 10.1136/gut.44.5.720 |
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| Title | Effective Endoscopic Ultrasound-Guided Transgastric Drainage in a Case of Subcutaneous Intractable Postoperative Pancreatic Fistula |
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