Management of pancreatic ductal leaks and fistulae

摘要: Pancreatic duct leaks can occur as a result of both acute and chronic pancreatitis or in the setting pancreatic trauma. Manifestations include pseudocysts, ascites, high amylase pleural effusions, disconnected syndrome, internal external fistulas. Patient presentations are highly variable range from asymptomatic cysts to patients with severe abdominal pain sepsis infected fluid collections. The diagnosis often be made by high-quality cross-sectional imaging during endoscopic retrograde cholangiopancreatography (ERCP). Because their complexity, leak best managed multidisciplinary team comprised therapeutic endoscopists, interventional radiologists, surgeons field interventions. Minor will resolve conservative management while frequently require Endoscopic treatments for have replaced surgical interventions many situations. Interventional radiologists also ability offer patients. mainstay endotherapy is transpapillary stenting stent that bridges if possible, but varies based on manifestation clinical presentation. Fluid collections leaks, such treated transluminal drainage without ultrasound percutaneous drainage. been shown effective an acceptable complication rate.