Clinical value of endoscopic retrograde pancreatic drainage for pancreatic fistula

Objective To evaluate the clinical value of endoscopic retrograde pancreatic drainage (ERPD) in patients with pancreatic fistula. Methods Data of 42 patients with pancreatic fistula, who were treated with ERPD at Changhai Hospital and Henan Provincial People's Hospital from June 2013 to September 2018, were collected. The pancreatic fistula curative rate, healing duration of pancreatic fistula, and the incidence of complications were analyzed. Results Among 42 patients with pancreatic fistula, there were 30 males (71.4%) and 12 females (28.6%) with mean age of 41.5±12.8 years old. Pancreatic duct stents of 37 cases (88.1%) went across the fistula. The overall curative rate was 90.5% (38/42) . The median healing duration of pancreatic fistula was 32.0 d (8-183 d) . The healing time of pancreatic fistula after injury (19.0±9.9 d, t=3.50, P=0.002) and of pancreatic fistula after surgery (20.3±10.7 d, t=3.35, P=0.003) were shorter than that of pancreatic fistula after acute severe pancreatitis (60.0±48.6 d) . The healing time of pancreatic fistula with pancreatic pseudocysts was longer than that of pancreatic fistula without pancreatic pseudocysts (65.3±55.4 d VS 32.6±23.6 d, t=2.21, P=0.040) . There were no significant differences in pancreatic fistula curative rate, pancreatic healing duration and times of ERCP in pancreatic fistula at different position.Postoperative stent-related complications occurred in 2 patients (4.8%) , and 1 patient (2.4%) developed mild pancreatitis. Conclusion ERPD is an important treating method with good therapeutic effect and low complications for pancreatic fistula. Key words: Stent; Pancreatic fistula; Endoscopic retrograde pancreatic drainage