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. 2017 Mar 27;5(2):6.
doi: 10.3390/medsci5020006.

Efficacy of Pancreatic Endotherapy In Pancreatic Ascites And Pleural Effusion

Sudhir Gupta  1 , Nitin Gaikwad  2 , Amol Samarth  3 , Niraj Sawalakhe  4 , Tushar Sankalecha  5
Affiliations

Efficacy of Pancreatic Endotherapy In Pancreatic Ascites And Pleural Effusion

Sudhir Gupta et al. Med Sci (Basel). .

Abstract

Pancreatic ascites and effusion is a challenging complication to manage, hence our aim was to evaluate the efficacy of pancreatic endotherapy in pancreatic ascites and pleural effusion. Endotherapy included endoscopic retrograde cholangiopancreatography (ERCP) with a pancreatogram and pancreatic stent placement across the leak in patients with pancreatic ascites/effusion. A total of 53 patients were included after successful cannulation. The male:female ratio was 7.8:1. The pancreatogram revealed a leak from the pancreatic duct in 20/53 (37.73%) patients. The most common leak site was the pancreatic body in 10/53 (18.9%) patients followed by the tail in 6/53 (11.32%) patients and the genu in 4/53 (7.5%) patients. In 29/53 (54.7%) patients, stent was placed beyond the leak site. Sphincterotomy was done in 7/53 (13.2%) patients, and in five patients with an obscure leak site, stent was placed empirically. A total of 39/53 (73.6%) patients benefited in terms of achieving the complete resolution of ascites and pleural effusion. The factors which were significant for the success of pancreatic endotherapy in the multivariate analysis were the site of the pancreatic ductal leak (p value = 0.008) and the ability of the stent to cross the leak site (p value = 0.004). To sum up, bridging the pancreatic ductal leak by stent offers a high rate of success. Pancreatic endotherapy is less invasive and highly effective in managing pancreatic ascites/pleural effusion.

Keywords: ascites; ductal leak; pancreatogram.

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Conflict of interest statement

No any conflict of interest.

Figures

Figure 1
Figure 1
Pancreatogram fluoroscopic images (a) Pancreatogram showing a leak in the midbody of the pancreas (arrow); (b) Pancreatogram showing a leak in the head region of the pancreas; (c) Plastic stent across the leak; (d) Distal end of pancreatic stent.
Figure 2
Figure 2
Treatment algorithm. CT: computed tomography; ERCP: endoscopic retrograde cholangiopancreatography.
See this image and copyright information in PMC

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