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The authors present two cases with two different approaches to dealing with disconnected duct syndrome in patients with a collection. In both cases the collection was communicating with the disconnected main pancreatic duct (MPD) in the tail. In the first case, after initial drainage of the collection using a lumen-apposing metal stent and plastic stent, the plastic stent was left in place for indirect drainage of the MPD in the tail. In the second case, transgastric drainage of the MPD was established using a pigtail stent that was placed through the MPD into the fluid collection. Diagnosis and drainage of a disconnected duct is essential in these cases to prevent recurrent events of acute pancreatitis. Indirect drainage through the collection is effective and the plastic stents can usually be left in place for a very long time.
Article published online:
25 August 2022
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