Saleem Atif, Sawyer Mark D, Baron Todd H
Division of GI and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.
JOP. 2010 Jan 8;11(1):69-71.
Pancreaticopleural fistula is a rare complication estimated to occur in 0.5% of the patients with pancreatitis and even extremely rare in surgically altered anatomy (e.g. Roux-en-Y anastomosis) patients. The conventional ERCP is difficult to treat pancreaticopleural fistula in a patient with complex upper GI anatomy because of long anatomical route.
We represent a case of a 47-year-old female with remote subtotal gastrectomy with Roux-en-Y gastrojejunostomy admitted with recurrent left pleural effusion due to pancreaticopleural fistula. After failed ERCP through the anatomical route, pancreaticopleural fistula was treated successfully with laparoscopy-assisted transjejunal ERCP.
Laparoscopy-assisted ERCP is a useful modality in patients with surgically altered anatomy.
胰胸膜瘘是一种罕见的并发症，据估计在胰腺炎患者中的发生率为0.5%，在解剖结构改变的手术患者（如Roux-en-Y吻合术）中极为罕见。由于解剖路径较长，传统的内镜逆行胰胆管造影术（ERCP）难以治疗上消化道解剖结构复杂的胰胸膜瘘患者。
我们报告一例47岁女性患者，因胰胸膜瘘导致反复左侧胸腔积液入院，该患者曾行远端胃大部切除术并Roux-en-Y胃空肠吻合术。经解剖路径进行的ERCP失败后，通过腹腔镜辅助经空肠ERCP成功治疗了胰胸膜瘘。
腹腔镜辅助ERCP对解剖结构改变的手术患者是一种有用的治疗方式。
