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Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis

Pancreatic fistulas belong to the most feared complications after surgery on or near the pancreas, abdominal trauma, or severe pancreatitis. The majority occur in the setting of operative interventions and are called postoperative pancreatic fistulas (POPF). They can lead to various complications, i...

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Autores principales: Meierhofer, Clara, Fuegger, Reinhold, Spaun, Georg O., Wundsam, Helwig Valentin, Kirchweger, Patrick, Biebl, Matthias, Schoefl, Rainer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342668/
https://www.ncbi.nlm.nih.gov/pubmed/37445564
http://dx.doi.org/10.3390/jcm12134531
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author Meierhofer, Clara
Fuegger, Reinhold
Spaun, Georg O.
Wundsam, Helwig Valentin
Kirchweger, Patrick
Biebl, Matthias
Schoefl, Rainer
author_facet Meierhofer, Clara
Fuegger, Reinhold
Spaun, Georg O.
Wundsam, Helwig Valentin
Kirchweger, Patrick
Biebl, Matthias
Schoefl, Rainer
author_sort Meierhofer, Clara
collection PubMed
description Pancreatic fistulas belong to the most feared complications after surgery on or near the pancreas, abdominal trauma, or severe pancreatitis. The majority occur in the setting of operative interventions and are called postoperative pancreatic fistulas (POPF). They can lead to various complications, including abscesses, delayed gastric emptying or hemorrhages with a significant impact on morbidity and mortality. Several risk factors have been identified, including smoking, high BMI, male gender, and age. Prophylactic measures and treatment options have been explored but with limited success. This study aimed to analyze the incidence and management of pancreatic fistulas treated in a tertiary referral center, particularly focusing on an endoscopic approach. The data of 60 patients with clinically relevant pancreatic fistulas were analyzed between 2018 and 2021. Different treatment approaches, including conservative management, percutaneous drainage, transpapillary stenting, and endoscopic transmural drainage, were evaluated. An endoscopic transmural approach using lumen-apposing metal stents (LAMS) was used in almost half of this cohort showing promising results, with a high rate of fistula closure in refractory cases and a mean time until closure of 2.7 months. The findings suggest that an endoscopic approach, particularly using LAMS, can be effective in the management of pancreatic fistulas.
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spelling pubmed-103426682023-07-14 Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis Meierhofer, Clara Fuegger, Reinhold Spaun, Georg O. Wundsam, Helwig Valentin Kirchweger, Patrick Biebl, Matthias Schoefl, Rainer J Clin Med Article Pancreatic fistulas belong to the most feared complications after surgery on or near the pancreas, abdominal trauma, or severe pancreatitis. The majority occur in the setting of operative interventions and are called postoperative pancreatic fistulas (POPF). They can lead to various complications, including abscesses, delayed gastric emptying or hemorrhages with a significant impact on morbidity and mortality. Several risk factors have been identified, including smoking, high BMI, male gender, and age. Prophylactic measures and treatment options have been explored but with limited success. This study aimed to analyze the incidence and management of pancreatic fistulas treated in a tertiary referral center, particularly focusing on an endoscopic approach. The data of 60 patients with clinically relevant pancreatic fistulas were analyzed between 2018 and 2021. Different treatment approaches, including conservative management, percutaneous drainage, transpapillary stenting, and endoscopic transmural drainage, were evaluated. An endoscopic transmural approach using lumen-apposing metal stents (LAMS) was used in almost half of this cohort showing promising results, with a high rate of fistula closure in refractory cases and a mean time until closure of 2.7 months. The findings suggest that an endoscopic approach, particularly using LAMS, can be effective in the management of pancreatic fistulas. MDPI 2023-07-06 /pmc/articles/PMC10342668/ /pubmed/37445564 http://dx.doi.org/10.3390/jcm12134531 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Meierhofer, Clara
Fuegger, Reinhold
Spaun, Georg O.
Wundsam, Helwig Valentin
Kirchweger, Patrick
Biebl, Matthias
Schoefl, Rainer
Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis
title Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis
title_full Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis
title_fullStr Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis
title_full_unstemmed Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis
title_short Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting—A Retrospective Data Analysis
title_sort endoscopic transmural therapy of pancreatic fistulas in an interdisciplinary setting—a retrospective data analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342668/
https://www.ncbi.nlm.nih.gov/pubmed/37445564
http://dx.doi.org/10.3390/jcm12134531
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