Cargando…
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...
Autores principales: | , , , , , , |
---|---|
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 |
_version_ | 1785072554319282176 |
---|---|
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. |
format | Online Article Text |
id | pubmed-10342668 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT meierhoferclara endoscopictransmuraltherapyofpancreaticfistulasinaninterdisciplinarysettingaretrospectivedataanalysis AT fueggerreinhold endoscopictransmuraltherapyofpancreaticfistulasinaninterdisciplinarysettingaretrospectivedataanalysis AT spaungeorgo endoscopictransmuraltherapyofpancreaticfistulasinaninterdisciplinarysettingaretrospectivedataanalysis AT wundsamhelwigvalentin endoscopictransmuraltherapyofpancreaticfistulasinaninterdisciplinarysettingaretrospectivedataanalysis AT kirchwegerpatrick endoscopictransmuraltherapyofpancreaticfistulasinaninterdisciplinarysettingaretrospectivedataanalysis AT bieblmatthias endoscopictransmuraltherapyofpancreaticfistulasinaninterdisciplinarysettingaretrospectivedataanalysis AT schoeflrainer endoscopictransmuraltherapyofpancreaticfistulasinaninterdisciplinarysettingaretrospectivedataanalysis |