skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF)

Abstract

Postoperative pancreatic fistula (POPF) with leakage of pancreatic juice is a rare, severe complication following pancreatic resection or, less commonly, splenectomy. Definitive treatment can require multidisciplinary approaches. We report a case of stenosis of the main pancreatic duct with distal tail GRADE C POPF, occurred after splenectomy for Hodgkin lymphoma, successfully treated with combined radiological-endoscopic approach.

Authors:
;  [1];  [2]; ; ; ;  [1];  [2];  [3];  [1]
  1. “Sapienza” University of Rome, Department of Radiological Sciences, Oncological and Anatomo-pathological Sciences, Vascular and Interventional Radiology Unit (Italy)
  2. “Sapienza” University of Rome, Department of General Surgery Paride Stefanini, Interventional Endoscopy Unit (Italy)
  3. Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Department of Radiology (Italy)
Publication Date:
OSTI Identifier:
22645469
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 9; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BEVERAGES; DUCTS; LEAKS; LYMPHOMAS; PANCREAS; SPLENECTOMY

Citation Formats

Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com, Sacconi, Beatrice, E-mail: beatrice.sacconi@fastwebnet.it, Cereatti, Fabrizio, E-mail: fcereatti@yahoo.com, Argirò, Renato, E-mail: renato.argiro@gmail.com, Corona, Mario, E-mail: mario.corona68@gmail.com, Bezzi, Mario, E-mail: mario.bezzi@uniroma1.it, Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it, Fiocca, Fausto, E-mail: fausto.fiocca@uniroma1.it, Saba, Luca, E-mail: lucasabamd@gmail.com, and Catalano, Carlo, E-mail: carlo.catalano@uniroma1.it. Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF). United States: N. p., 2016. Web. doi:10.1007/S00270-016-1332-3.
Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com, Sacconi, Beatrice, E-mail: beatrice.sacconi@fastwebnet.it, Cereatti, Fabrizio, E-mail: fcereatti@yahoo.com, Argirò, Renato, E-mail: renato.argiro@gmail.com, Corona, Mario, E-mail: mario.corona68@gmail.com, Bezzi, Mario, E-mail: mario.bezzi@uniroma1.it, Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it, Fiocca, Fausto, E-mail: fausto.fiocca@uniroma1.it, Saba, Luca, E-mail: lucasabamd@gmail.com, & Catalano, Carlo, E-mail: carlo.catalano@uniroma1.it. Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF). United States. doi:10.1007/S00270-016-1332-3.
Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com, Sacconi, Beatrice, E-mail: beatrice.sacconi@fastwebnet.it, Cereatti, Fabrizio, E-mail: fcereatti@yahoo.com, Argirò, Renato, E-mail: renato.argiro@gmail.com, Corona, Mario, E-mail: mario.corona68@gmail.com, Bezzi, Mario, E-mail: mario.bezzi@uniroma1.it, Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it, Fiocca, Fausto, E-mail: fausto.fiocca@uniroma1.it, Saba, Luca, E-mail: lucasabamd@gmail.com, and Catalano, Carlo, E-mail: carlo.catalano@uniroma1.it. 2016. "Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF)". United States. doi:10.1007/S00270-016-1332-3.
@article{osti_22645469,
title = {Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF)},
author = {Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com and Sacconi, Beatrice, E-mail: beatrice.sacconi@fastwebnet.it and Cereatti, Fabrizio, E-mail: fcereatti@yahoo.com and Argirò, Renato, E-mail: renato.argiro@gmail.com and Corona, Mario, E-mail: mario.corona68@gmail.com and Bezzi, Mario, E-mail: mario.bezzi@uniroma1.it and Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it and Fiocca, Fausto, E-mail: fausto.fiocca@uniroma1.it and Saba, Luca, E-mail: lucasabamd@gmail.com and Catalano, Carlo, E-mail: carlo.catalano@uniroma1.it},
abstractNote = {Postoperative pancreatic fistula (POPF) with leakage of pancreatic juice is a rare, severe complication following pancreatic resection or, less commonly, splenectomy. Definitive treatment can require multidisciplinary approaches. We report a case of stenosis of the main pancreatic duct with distal tail GRADE C POPF, occurred after splenectomy for Hodgkin lymphoma, successfully treated with combined radiological-endoscopic approach.},
doi = {10.1007/S00270-016-1332-3},
journal = {Cardiovascular and Interventional Radiology},
number = 9,
volume = 39,
place = {United States},
year = 2016,
month = 9
}
  • Short communication.
  • We describe an innovative interventional technique for the repair of a postoperative enterocutaneous fistula (ECF). In the reported case, surgical repair of the ECF was contraindicated, while endoscopic closure was unsuccessful. Correction of this high-outflow fistula was achieved using an Amplatzer septal occluder, which was deployed under simultaneous fluoroscopic and endoscopic guidance. The use of an Amplatzer septal occluder should be taken into consideration when there is a need to treat high-outflow ECF in patients who cannot undergo surgery.
  • Pancreas fistula is a well-known and severe complication of pancreaticoduodenectomy. It is difficult to control with conservative therapy, inducing further complications and severe morbidity. Until now, re-operation has been the only way to resolve pancreatic fistula causing complete dehiscence of the pancreatic-enteric anastomosis (complete pancreatic fistula). Percutaneous transgastric fistula drainage is one of the treatments for pancreatic fistula. This procedure allows both pancreas juice drainage and anastomosis re-construction at the same time. This is effective and minimally invasive but difficult to adapt to a long or complicated fistula. In particular, dilatation of the main pancreatic duct is indispensable. This papermore » reports the successful resolution of a postoperative pancreatic fistula by a two-way-approach percutaneous transgastric fistula drainage procedure. Using a snare catheter from the fistula and a flexible guidewire from the transgastric puncture needle, it can be performed either with or without main pancreatic duct dilatation.« less
  • PurposeThe present study was performed to define the results of the endovascular treatment with angioplasty and distal radial artery embolization in ischemic steal syndrome associated with forearm arteriovenous accesses.MethodThe cases referred to our interventional radiology unit with symptoms and physical examination findings suggestive of ischemic steal syndrome were retrospectively evaluated first by Doppler ultrasonography, and then by angiography. Cases with proximal artery stenosis were applied angioplasty, and those with steal syndrome underwent coil embolization to distal radial artery.ResultsOf 589 patients who underwent endovascular intervention for dialysis arteriovenous fistulae (AVF)-associated problems, 6 (1.01 %) (5 female, 1 males; mean age 62 (rangemore » 41–78) with forearm fistula underwent combined endovascular treatment for steal syndrome. In addition to steal phenomenon, there were stenosis and/or occlusion in proximal radial and/or ulnar artery in 6 patients concurrently. Embolization of distal radial artery and angioplasty to proximal arterial stenoses were performed in all patients. Ischemic symptoms were eliminated in all patients and the AVF were in use at the time of study. In one patient, ischemic symptoms recurring 6 months later were alleviated by repeat angioplasty of ulnar artery.ConclusionIn palmar arch steal syndrome affecting forearm fistulae, combined distal radial embolization and angioplasty is also an effective treatment method in the presence of proximal radial and ulnar arterial stenoses and occlusions.« less
  • This is a report on two cases of large bile leak following right hepatectomy performed for living related liver transplantation, originating from the stump of the ligated right bile duct, and treated with the placement of large percutaneous biliary catheters through a combined percutaneous transhepatic and endoscopic approach (rendezvous technique).