EUS-guided Transgastric Drainage to Manage a Postoperative Pancreatic Fistula After Distal Pancreatectomy and Splenectomy in Recurrent Ovarian Cancer: A Case Report

Anticancer Res. 2021 Jul;41(7):3649-3656. doi: 10.21873/anticanres.15155.

Abstract

Background/aim: Postoperative pancreatic fistula after distal pancreatectomy represents the most frequent procedure-related complication; however, a standard treatment is currently not available.

Case report: We herein report a case of postoperative pancreatic fistula after distal pancreatectomy and splenectomy in a patient affected by a platinum-sensitive ovarian cancer recurrence. The 59-year-old patient developed a pancreatic fistula on postoperative day 4. An endoscopic transgastric double-pigtail drainage was placed on postoperative day 13. The patient was discharged after 5 days and referred to adjuvant medical treatment. A month later, computed tomography revealed complete resolution of the fistula, the drainage was removed, and the patient continued chemotherapy. She recovered uneventfully at a 3-month follow-up.

Conclusion: EUS-guided drainage is a viable option in the management of postoperative pancreatic fistula, which can lead to a rapid resolution of peripancreatic fluid collections and to initiation of adjuvant chemotherapy with the slightest delay in ovarian cancer patients.

Keywords: EUS-guided transgastric drainage; Pancreatic fistula; distal pancreatectomy; endoscopic ultrasound; interventional EUS; ovarian cancer; pancreas surgery; postoperative complication.

Publication types

  • Case Reports

MeSH terms

  • Drainage / methods
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm Recurrence, Local / therapy*
  • Ovarian Neoplasms / surgery*
  • Ovarian Neoplasms / therapy*
  • Pancreas / surgery
  • Pancreatectomy / methods
  • Pancreatic Fistula / surgery*
  • Pancreatic Fistula / therapy*
  • Postoperative Period
  • Splenectomy / methods