Postoperative pancreatic fistula resolved through endoscopic ultrasound-guided pancreaticogastrostomy of the pancreatic tail

Abstract Text We present the case of a 54-year-old male with chronic pancreatitis. A CT scan revealed a “ruptured” spleen with hemoperitoneum, requiring urgent splenectomy with partial resection of the pancreatic tail. Postoperatively, the patient developed a pancreatic fistula. In an initial ERCP through the minor papilla, dorsal duct amputation with disconnection from the proximal pancreas was observed, making cannulation of the pancreatic tail impossible. In a second procedure, endoscopic ultrasound was used to retrogradely locate the caudal pancreatic duct. A guidewire was successfully passed to the proximal duct. The parietal fistula was dilated with a 6F cystotome. Finally, a multiperforated 7F, 8 cm pancreatic plastic stent was successfully placed, achieving good clinical evolution.

Video http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/945abad3-c804-4956-b587-c1d57709fb2a/Uploads/16849_Postoperative_pancreatic%20fistula%20resolved%20through%20endoscopic%20ul....mp4

Publication History

Article published online:
27 March 2025