Abstract
ABSTRACT Introduction:Pancreaticopleural fistula is a rare complication of chronic pancreatitis. Objective:To describe pancreaticopleural fistula due to chronic pancreatitis and perform an extensive review of literature on this topic. Methods:Comprehensive narrative review through online research on the databases Medline and Lilacs for articles published over the last 20 years. There were 22 case reports and four case series selected. Results:The main indication for surgical treatment is the failure of clinical and/or endoscopic treatments. Surgery is based on internal pancreatic drainage, especially by means of pancreaticojejunostomy, and/or pancreatic resections. Conclusion:Pancreaticopleural fistula is a rare complication of chronic pancreatitis and the Frey procedure may be an appropriate therapeutic option in selected cases when clinical and endoscopic treatments are unsuccessful.
Highlights
Chronic pancreatitis is a progressive and irreversible inflammatory process characterized by the replacement of the pancreatic parenchyma by fibrotic tissue
This study aims to describe pancreaticopleural fistulas caused by chronic pancreatitis and perform a review of the current literature on this topic
To the total amount of cases related in the literature over 20 years period, two cases of pancreaticopleural fistula attended in authors institutions, based on retrospective analysis of data collected on medical records
Summary
Chronic pancreatitis is a progressive and irreversible inflammatory process characterized by the replacement of the pancreatic parenchyma by fibrotic tissue. It is estimated to occur in 0.4% of patients with pancreatitis, mostly resulting from chronic alcoholic pancreatitis[10] It corresponds to a condition in which pancreatic secretions drain directly into the pleural cavity, resulting from a chronic inflammatory process, acute inflammation or traumatic or iatrogenic rupture of the pancreatic duct. It presents as massive and relapsing pleural effusions, often on the left side and with high content of pancreatic amylase[34]. This study aims to describe pancreaticopleural fistulas caused by chronic pancreatitis and perform a review of the current literature on this topic
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