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Management of Disconnected Pancreatic Duct Syndrome

  • Pancreas (T Stevens, Section Editor)
  • Published:
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Opinion statement

A disconnected pancreatic duct most commonly follows an episode of severe pancreatitis and walled-off necrosis (WON). When the latter is drained percutaneously, a pancreatic fistula connected to an upstream and disconnected duct is commonly seen. Transgastric drainage of WON with or without concomitant percutaneous drainage (dual drainage) will allow placement of two pigtail stents to drain the upstream duct and ultimately allows removal of percutaneous tubes and avoids the need for distal pancreatectomy. These stents should be left in place indefinitely. In patients referred with percutaneous drains and a disconnected pancreatic duct but without a concomitant fluid collection, a combined procedure, in which an interventional radiologist places a TIPS needle into the drain tract to puncture the stomach, allows the endoscopist access to dilate and stent the tract in a manner comparable to pseudocyst drainage. These stents should be left indefinitely, unless subsequent imaging demonstrates atrophy of the disconnected pancreatic tail.

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References and Recommended Reading

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Authors and Affiliations

  1. Gastroenterology Division, Digestive Disease Institute, Virginia Mason Medical Center, 1100 Ninth Avenue, C3-GAS, Seattle, WA, 98101, USA

    Michael Larsen MD & Richard A. Kozarek MD

  2. Virginia Mason Medical Center, 1100 Ninth Avenue, C3-GAS, Seattle, WA, 98101, USA

    Michael Larsen MD

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  1. Michael Larsen MD
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  2. Richard A. Kozarek MD
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Correspondence to Michael Larsen MD.

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Michael Larsen declares that he has no conflict of interest. Richard A. Kozarek declares that he has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Pancreas

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Larsen, M., Kozarek, R.A. Management of Disconnected Pancreatic Duct Syndrome. Curr Treat Options Gastro 14, 348–359 (2016). https://doi.org/10.1007/s11938-016-0098-7

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  • DOI: https://doi.org/10.1007/s11938-016-0098-7

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