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Complications of Long-Term Indwelling Transmural Double Pigtail Stent Placement for Symptomatic Peripancreatic Fluid Collections

  • Hiroshi YamauchiEmail author
  • Tomohisa Iwai
  • Mitsuhiro Kida
  • Kosuke Okuwaki
  • Takahiro Kurosu
  • Masafumi Watanabe
  • Kai Adachi
  • Masayoshi Tadehara
  • Hiroshi Imaizumi
  • Wasaburo Koizumi
Original Article
  • 12 Downloads

Abstract

Background

Endoscopic transmural drainage is performed for symptomatic peripancreatic fluid collections (PPFCs). Long-term transmural double-pigtail stent (DPS) placement is useful in preventing recurrences. There are few reports on the long-term safety of DPS placement. Thus, this study aimed to examine the complications of long-term indwelling DPS for PPFCs.

Methods

Among 53 patients who underwent endoscopic ultrasound-guided transmural drainage for symptomatic PPFCs between April 2006 and March 2017, those followed up for over one year were included. Complications of long-term indwelling DPS were examined retrospectively.

Results

This study enrolled 36 patients [30 men, median age 54 years (range 22–82)]. Walled-off necrosis was present in 22 cases (including 9 disconnected pancreatic duct syndrome cases) and pancreatic pseudocysts, in 14 cases. The median stenting period was 20.9 (range 0.8–142.3) months, and median observation period was 56.2 (range 12.4–147.1) months. Colon perforation due to DPS occurred in 3 cases (8.3%), at 5.8, 17.1, and 33.7 months after indwelling DPS placement; 2 cases developed perforation from the serosal side. In 1 case, the patient was treated surgically, and in 2 cases, the patients underwent endoscopic removal of the stent and showed improvement with conservative treatment.

Conclusion

Long-term indwelling transmural DPS for symptomatic PPFCs poses a risk of intestinal perforation. Thus, if possible, it may be better to avoid long-term placement.

Keywords

Transmural indwelling stent Perforation Pancreatic fluid collections Double-pigtail stent 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to disclose.

Ethical statement

The study protocol was approved by the hospital’s ethics review board.

Informed consent

Informed consent was obtained from all patients before treatment.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hiroshi Yamauchi
    • 1
    Email author
  • Tomohisa Iwai
    • 1
  • Mitsuhiro Kida
    • 1
  • Kosuke Okuwaki
    • 1
  • Takahiro Kurosu
    • 1
  • Masafumi Watanabe
    • 1
  • Kai Adachi
    • 1
  • Masayoshi Tadehara
    • 1
  • Hiroshi Imaizumi
    • 1
  • Wasaburo Koizumi
    • 1
  1. 1.Department of GastroenterologyKitasato University School of MedicineSagamiharaJapan

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