Endoscopic transpapillary drainage in disconnected pancreatic duct syndrome after acute pancreatitis and trauma: long-term outcomes in 31 patients

作者：Yan Chen, Yueping Jiang, Wei Qian, Qihong Yu, Yuanhang Dong, Huiyun Zhu, Feng Liu, Yiqi Du, Dong Wang, Zhao‐Shen Li · 发表于：BMC Gastroenterology · 年份：2019 · DOI：10.1186/s12876-019-0977-1 · 被引用次数：63 · 研究领域：Pancreatitis Pathology and Treatment、Gallbladder and Bile Duct Disorders、Abdominal Trauma and Injuries

BACKGROUND: Conventionally, disconnected pancreatic duct syndrome is treated surgically. Endoscopic management is associated with lesser morbidity and mortality than that observed with surgery and shows similar success rates. However, limited data are available in this context. We evaluated the efficacy of endotherapeutic management for this syndrome. METHODS: We prospectively obtained data of patients with disconnected pancreatic duct syndrome between September 2008 and January 2016. Demographic and clinical data were assessed, and factors affecting clinical outcomes were statistically analyzed. RESULTS: Thirty-one patients underwent 40 endoscopic transpapillary procedures, and 1 patient developed an infection after prosthesis insertion. Etiological contributors to disconnected pancreatic duct syndrome were abdominal trauma (52%) and acute necrotizing pancreatitis (48%). The median interval between the appearance of pancreatic leaks and disconnected pancreatic duct syndrome was 6.6 months (range 0.5-84 months). The median follow-up after the last treatment procedure was 38 months (range 17-99 months). Patients with complete main pancreatic duct disruption in the body/tail showed a low risk of pancreatic atrophy (P = 0.009). This study highlighted the significant correlation between endoscopic transpapillary drainage and clinical success (P = 0.014). CONCLUSIONS: Disconnected pancreatic duct syndrome is not an uncommon sequel of pancreatic injury, and much of the delayed diag...