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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...

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Detalles Bibliográficos
Autores principales: Meierhofer, Clara, Fuegger, Reinhold, 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/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.
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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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