Endoscopy 2020; 52(S 01): S190
DOI: 10.1055/s-0040-1704592
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 15:00 – 15:30 ERCP: Benign pancreatic disease ePoster Podium 2
© Georg Thieme Verlag KG Stuttgart · New York

PANCREATIC LEAKS TREATED ACCORDING TO AN ENDOSCOPY-ORIENTED CLASSIFICATION: A TERTIARY-CARE CENTER EXPERIENCE

G Bonato
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
,
L Dioscoridi
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
,
M Cintolo
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
,
E Forti
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
,
F Pugliese
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
,
A Giannetti
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
,
A Italia
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
,
R Rosa
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
,
M Mutignani
1   ASST Grande Ospedale Metropolitano Niguarda, Digestive and Interventional Endoscopy, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims In recent years, advances in interventional endoscopy have led to a substantial change in management algorithm of pancreatic leaks and fistula [2]. In 2017 our group proposed a new classification which combines anatomical and functional criteria with the purpose of guiding physicians in selecting the appropriate endoscopic treatment strategy for such conditions [3]. Aim of this study was to evaluate the validity and clinical usefulness of an endoscopy-oriented classification for pancreatic leaks in a clinical setting.

Methods All patients who underwent ERCP for pancreatic leaks between 1st February 2012 and 31th March 2019 were retrospectively reviewed. We gathered the following data: patients demographics, etiology of the leak, type of endoscopic treatment, success, number of procedures and adverse events

Results from 1st February 2012 to 31th March 2019, 67 patients who underwent endoscopic treatment for pancreatic leaks or fistula. In most cases pancreatic duct leaks occurred as a result of acute pancreatitis (n = 21), pancreatic or abdominal surgery (n = 41) or pancreatic trauma (n = 5). Pancreatic leaks were classified as type I (n = 10), type II (n = 27) and type III (n = 28) according to our endoscopy-oriented classification and treatment strategy were consistently selected. Overall technical success was 100% while clinical success was achieved in 89.2% of patients. At univariate analysis, only presence of sepsis and older age resulted associated with lower success. Clinical success required a mean of 1,9 procedures for patient (range 1 to 4 procedures).

Conclusions Our single-center experience shows excellent success rates achieved by tailoring treatment on the anatomic and functional features of the leak according to the above-mentioned classification. An endoscopy-oriented classification could lead to a better standardization of treatment, guide physician in the clinical setting and improve outcomes.