Laparoscopy Assisted Transjejunal ERCP for Treatment of Pancreaticopleural Fistula

  • Atif Saleem Division of GI and Hepatology, Mayo Clinic. Rochester, MN, USA
  • Mark D Sawyer Department of Surgery, Mayo Clinic. Rochester, MN, USA
  • Todd H Baron Division of GI and Hepatology, Mayo Clinic. Rochester, MN, USA
DOI: https://doi.org/10.6092/1590-8577/3876
Keywords: Anastomosis, Roux-en-Y, Cholangiopancreatography, Endoscopic Retrograde, Hydrothorax, Pancreatic Fistula /therapy

Abstract

Context Pancreaticopleural fistula is a rare complication estimated to occur in 0.5% of the patients with pancreatitis and even extremely rare in surgically altered anatomy (e.g. Roux-en-Y anastomosis) patients. The conventional ERCP is difficult to treat pancreaticopleural fistula in a patient with complex upper GI anatomy because of long anatomical route. Case report We represent a case of a 47-year-old female with remote subtotal gastrectomy with Roux-en-Y gastrojejunostomy admitted with recurrent left pleural effusion due to pancreaticopleural fistula. After failed ERCP through the anatomical route, pancreaticopleural fistula was treated successfully with laparoscopy-assisted transjejunal ERCP. Conclusion Laparoscopy-assisted ERCP is a useful modality in patients with surgically altered anatomy.

Image: Radiographic image showing endoscope in position passed retrograde.

Downloads

Download data is not yet available.

References

Feitoza AB, Baron TH. Endoscopy and ERCP in the setting of previous upper GI tract surgery. Part II: postsurgical anatomy with alteration of the pancreaticobiliary tree. Gastrointest Endosc 2002; 55:75-9. [PMID 11756919] (FULL TEXT: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WFY-461K4GH-1R&_user=606145&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000031398&_version=1&_urlVersion=0&_userid=606145&md5=25608291119a5fbcc997782447a4d1f3)

Feitoza AB, Baron TH. Endoscopy and ERCP in the setting of previous upper GI tract surgery. Part I: reconstruction without alteration of pancreaticobiliary anatomy. Gastrointest Endosc 2001; 54:743-9. [PMID 11726851] (FULL TEXT: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WFY-46272BF-C&_user=606145&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000031398&_version=1&_urlVersion=0&_userid=606145&md5=f94995436ee7d27e2e410ffec3d987fd)

Dapri G, Himpens J, Buset M, Vasilikostas G, Ntounda R, Cadière GB. Laparoscopic transgastric access to the common bile duct after Roux-en-Y gastric bypass. Surg Endosc 2009; 23:1646-8. [PMID 19343441] (FULL TEXT: http://www.springerlink.com/content/5251360q5520q502/fulltext.pdf)

Mergener K, Kozarek RA, Traverso LW. Intraoperative transjejunal ERCP: case reports. Gastrointest Endosc 2003; 58:461-3. [PMID 14528232] (FULL TEXT: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WFY-49MDNM8-14&_user=606145&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000031398&_version=1&_urlVersion=0&_userid=606145&md5=e2febd37ddcf581c17a75f98c93362a9)

Radiographic image showing endoscope in position passed retrograde
Published
2016-07-13
How to Cite
SaleemA., SawyerM., & BaronT. (2016). Laparoscopy Assisted Transjejunal ERCP for Treatment of Pancreaticopleural Fistula. JOP. Journal of the Pancreas, 11(1), 69-71. https://doi.org/10.6092/1590-8577/3876
Issue
Vol 11 No 1 (2010): January - P. 1-94
Section
CASE REPORTS

Copyright (c) 2010 Atif Saleem, Mark D Sawyer, Todd H Baron

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

As a member of Publisher International Linking Association, PILA, iMedPub Group’s JOP follows the Creative Commons Attribution License and Scholars Open Access publishing policies. Journal of the Pancreas is the Council Contributor Member of Council of Science Editors (CSE) and following the CSE slogan Education, Ethics, and Evidence for Editors.