Download PDF
Endoscopy 2006; 38(7): 749-751
DOI: 10.1055/s-2006-925062
Case Report
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Management of Pancreaticopleural Fistulas: A Report of Three Patients

T.  Koshitani1 , Y.  Uehara1 , T.  Yasu1 , Y.  Yamashita1 , T.  Kirishima1 , N.  Yoshinami1 , J.  Takaaki1 , H.  Shintani1 , K.  Kashima1 , H.  Ogasawara2 , Y.  Katsuma3 , T.  Okanoue4
  • 1 Department of Gastroenterology, Kyoto City Hospital, Kyoto, Japan
  • 2 Ogasawara Clinic, Kyoto, Japan
  • 3 Katsuma Clinic, Kyoto, Japan
  • 4 Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
Further Information

Publication History

Submitted 12 April 2005

Accepted after revision 25 November 2005

Publication Date:
23 March 2006 (online)

Also available at
    Permissions and Reprints

Pancreaticopleural fistulas are a rare complication of acute or chronic pancreatitis, and are usually treated by surgery. We report three patients whose pancreaticopleural fistulas were successfully treated by endoscopic retrograde cholangiopancreatography and drainage (stenting, nasopancreatic drainage). In one patient a pancreatic pseudocyst persisted despite successful initial closure of the leak using this method and, as it was also suspected to be infected, additional drainage of the pseudocyst was required. Endotherapy of pancreaticopleural fistulas could obviate the need for surgery when conventional medical treatment has failed in this condition.

References

  • 1 Rockey D C, Cello J P. Pancreaticopleural fistula: report of 7 patients and review of the literature.  Medicine. 1990;  69 332-344
    PubMedGoogle Scholar
  • 2 Uchiyama T, Suzuki T, Adachi A. et al . Pancreatic pleural effusion: case report and review of 113 cases in Japan.  Am J Gastroenterol. 1992;  87 387-391
    PubMedGoogle Scholar
  • 3 Kaye M D. Pleuropulmonary complications of pancreatitis.  Thorax. 1968;  23 297-306
    CrossrefPubMedGoogle Scholar
  • 4 Cameron J L. Chronic pancreatic ascites and pancreatic pleural effusions.  Gastroenterology. 1978;  74 134-140
    PubMedGoogle Scholar
  • 5 Pottmeyer E W, Frey C F, Matsuno S. Pancreaticopleural fistulas.  Arch Surg. 1987;  122 648-654
    PubMedGoogle Scholar
  • 6 Saeed Z A, Ramirez F C, Hepps K S. Endoscopic stent placement for internal and external pancreatic fistulas.  Gastroenterology. 1993;  105 1213-1217
    CrossrefPubMedGoogle Scholar
  • 7 Garcia-Ricart F, Croizet O, EI Riwini M, Escourrou J. Endoscopic management of a persistent pancreatopleural fistula.  Gastrointest Endosc. 1997;  46 359-361
    CrossrefPubMedGoogle Scholar
  • 8 Safadi B Y, Marks J M. Pancreatic-pleural fistula: the role of ERCP in diagnosis and treatment.  Gastrointest Endosc. 2000;  51 213-215
    CrossrefPubMedGoogle Scholar
  • 9 Neher J R, Brady P G, Pinkas H, Ramos M. Pancreaticopleural fistula in chronic pancreatitis: resolution with endoscopic therapy.  Gastrointest Endosc. 2000;  52 416-418
    CrossrefPubMedGoogle Scholar
  • 10 Miyachi A, Kikuyama M, Matsubayashi Y. et al . Successful treatment of pancreaticopleural fistula by nasopancreatic drainage and endoscopic removal of pancreatic duct calculi: a case report.  Gastrointest Endosc. 2004;  59 454-457
    CrossrefPubMedGoogle Scholar
  • 11 Tajima Y, Fukuda K, Tsuneoka N. et al . Demonstration of a pancreaticopleural fistula with magnetic resonance cholangiopancreatography.  Am J Surg. 2004;  187 741-742
    CrossrefPubMedGoogle Scholar
  • 12 Dhebri A R, Ferran N. Nonsurgical management of pancreaticopleural fistula.  JOP. 2005;  6 152-161
    PubMedGoogle Scholar
  • 13 Lipsett P A, Cameron J L. Internal pancreatic fistula.  Am J Surg. 1992;  163 216-220
    CrossrefPubMedGoogle Scholar

T. Koshitani, M.D.

Department of Gastroenterology

Kyoto City Hospital · 1-2 Higashitakada-cho Mibu Nakagyo-ku · Kyoto 604-8845 · Japan

Fax: +81-75-321-6025

Email: tkoshi@hosp.city.kyoto.jp

      >