gms | German Medical Science

127. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

20.04. - 23.04.2010, Berlin

Fast recovery following minimally invasive approach for pancreatic duct injury

Meeting Abstract

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  • Michaela Köhler - Universitäts-Kinderspital beider Basel, Kinderchirurgische Universitätsklinik, Basel, Schweiz
  • Johannes Mayr - Universitäts-Kinderspital beider Basel, Kinderchirurgische Universitätsklinik, Basel, Schweiz
  • Frank-Martin Häcker - Universitäts-Kinderspital beider Basel, Kinderchirurgische Universitätsklinik, Basel, Schweiz

Deutsche Gesellschaft für Chirurgie. 127. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 20.-23.04.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10dgch614

DOI: 10.3205/10dgch614, URN: urn:nbn:de:0183-10dgch6140

Veröffentlicht: 17. Mai 2010

© 2010 Köhler et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: The management of paediatric pancreatic trauma remains controversial. In patients with ductal disruption some authors recommend early surgery in order to decrease duration of parenteral nutrition and prevent pseudocyst formation. We followed a minimally invasive approach for the same goals but aiming also for a shorter postoperative course and hospital stay.

Materials and methods: We report two cases (6 and 7 years respectively) presenting to our hospital with increasing abdominal pain following a handlebar injury. Further investigations with ultrasonography and CT scan showed signs of pancreatic duct lesions with fluid collection. Patients were immediately started on TPN and Octreotide. As soon as the overseas ordered Pigtail stents (5 Fr diameter, 7cm length) had arrived, ERCP was performed and placement of the pigtail stent beyond the site of duct lesion could be achieved.

Results: One day after stent placement the patients were asymptomatic. They started on clear fluids shortly after the procedure followed by build-up of oral nutrition the following day. Patients were discharged 7 and 2 days respectively following stenting and controlled with regular ultrasounds. In the first patient, the initial fluid collection was disappeared after 3 weeks. The second patient had no pseudocyst detectable on ultrasonography on day 2. The stent was removed as day surgery after 4 weeks in teh first and after 9 weeks in the second patient. On follow-up after stent removal abdominal ultrasound showed normal pancreas with no signs of fluid collection. Twenty and nine months following stent removal the children remain completely asymptomatic.

Conclusion: In our 2 children with traumatic pancreatic duct lesion, minimal invasive stenting of the pancreatic duct was feasible, abbreviated the natural course of pancreatic duct injury, and inhibited the development of pseudocyst formation