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Pancreatic Fistulas: Current Evidence and Strategy—A Narrative Review
Pancreatic fistulas are highly feared complications following surgery on or near the pancreas, abdominal trauma, or severe inflammation. These fistulas arise from leaks in the pancreatic ductal system, leading to various complications such as abscesses, delayed gastric emptying, and hemorrhage. Seve...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10419817/ https://www.ncbi.nlm.nih.gov/pubmed/37568446 http://dx.doi.org/10.3390/jcm12155046 |
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author | Meierhofer, Clara Fuegger, Reinhold Biebl, Matthias Schoefl, Rainer |
author_facet | Meierhofer, Clara Fuegger, Reinhold Biebl, Matthias Schoefl, Rainer |
author_sort | Meierhofer, Clara |
collection | PubMed |
description | Pancreatic fistulas are highly feared complications following surgery on or near the pancreas, abdominal trauma, or severe inflammation. These fistulas arise from leaks in the pancreatic ductal system, leading to various complications such as abscesses, delayed gastric emptying, and hemorrhage. Severe cases present with sepsis or organ failure, dramatically increasing mortality and morbidity. Risk factors include smoking, high BMI, male gender, age, and surgery-related factors like prolonged operation time and non-ligation of the main pancreatic duct. Therefore, treatment options and preventive measurements have become a hot topic in recent years. Studies have investigated the use of fibrin sealants, different closure methods, and less invasive surgical techniques. Treatment options consist of conservative measurements and the use of percutaneous drainage, prophylactic transpapillary stenting, and surgery in severe cases. As EUS has become widely available, transmural stenting started to influence the management of pancreatic fluid collections (PFCs). However, studies on its use for the management of pancreatic fistulas are lacking. Medical treatment options like somatostatin analogs and pasireotide have been investigated but yielded mixed results. |
format | Online Article Text |
id | pubmed-10419817 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104198172023-08-12 Pancreatic Fistulas: Current Evidence and Strategy—A Narrative Review Meierhofer, Clara Fuegger, Reinhold Biebl, Matthias Schoefl, Rainer J Clin Med Review Pancreatic fistulas are highly feared complications following surgery on or near the pancreas, abdominal trauma, or severe inflammation. These fistulas arise from leaks in the pancreatic ductal system, leading to various complications such as abscesses, delayed gastric emptying, and hemorrhage. Severe cases present with sepsis or organ failure, dramatically increasing mortality and morbidity. Risk factors include smoking, high BMI, male gender, age, and surgery-related factors like prolonged operation time and non-ligation of the main pancreatic duct. Therefore, treatment options and preventive measurements have become a hot topic in recent years. Studies have investigated the use of fibrin sealants, different closure methods, and less invasive surgical techniques. Treatment options consist of conservative measurements and the use of percutaneous drainage, prophylactic transpapillary stenting, and surgery in severe cases. As EUS has become widely available, transmural stenting started to influence the management of pancreatic fluid collections (PFCs). However, studies on its use for the management of pancreatic fistulas are lacking. Medical treatment options like somatostatin analogs and pasireotide have been investigated but yielded mixed results. MDPI 2023-07-31 /pmc/articles/PMC10419817/ /pubmed/37568446 http://dx.doi.org/10.3390/jcm12155046 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 | Review Meierhofer, Clara Fuegger, Reinhold Biebl, Matthias Schoefl, Rainer Pancreatic Fistulas: Current Evidence and Strategy—A Narrative Review |
title | Pancreatic Fistulas: Current Evidence and Strategy—A Narrative Review |
title_full | Pancreatic Fistulas: Current Evidence and Strategy—A Narrative Review |
title_fullStr | Pancreatic Fistulas: Current Evidence and Strategy—A Narrative Review |
title_full_unstemmed | Pancreatic Fistulas: Current Evidence and Strategy—A Narrative Review |
title_short | Pancreatic Fistulas: Current Evidence and Strategy—A Narrative Review |
title_sort | pancreatic fistulas: current evidence and strategy—a narrative review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10419817/ https://www.ncbi.nlm.nih.gov/pubmed/37568446 http://dx.doi.org/10.3390/jcm12155046 |
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