• Felix I Téllez-Aviña, Luis E Casasola-Sánchez, Miguel Á Ramírez-Luna, Ángela Saúl, Enrique Murcio-Pérez, Carlos Chan, Luis Uscanga, Gilberto Duarte-Medrano, and Francisco Valdovinos-Andraca.
• National Institute Medical Sciences and Nutrition Salvador Zubiran.
• J. Clin. Gastroenterol. 2018 Jan 1; 52 (1): 85-90.

IntroductionDisconnected pancreatic duct syndrome (DPDS) is defined as the complete disruption of the main pancreatic duct, the result are peripancreatic fluid collections or pancreatic leaks. The aim of this study was to report the results of derivative endoscopic treatment of DPDS in a long-term follow-up period.Patients And MethodsWe performed a retrospective analysis of prospectively collected data. Endoscopic treatment consisted of transmural drainage with 2 double pigtail plastic stents (7 F and 4 cm) deployed under endoscopic ultrasound guidance.ResultsIn total, 21 patients were included in our study. There were 15 (71%) men and the median age was 36 years (range, 23 to 86 y). The principal etiology of DPDS was acute pancreatitis. A total of 20 (95.2%) patients were diagnosed with DPDS by endoscopic pancreatography and only 1 (4.8%) patient by magnetic resonance cholangiopancreatography (MRCP). The median follow-up time was 28 months (range, 7 to 76 mo). Technique success was 100% and initial clinical success was 80.9% (17/21). Three (17.6%) of these patients required a new endoscopic procedure with success in all cases. During follow-up, 11 (52%) patients developed diabetes mellitus and 3 patients (14%) developed exocrine pancreatic insufficiency. There were 5 (15%) patients with complications.ConclusionAccording to our data, endoscopic treatment with the placement of a permanent indwelling transmural stents is a useful and safe tool for the treatment of DPDS.

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