Pancreatic fistula: A proposed percutaneous procedure

Figure 1 Flow chart of two-step (on the left) and one-step (on the right) procedures. PF: Pancreatic fistula; CT: Computer tomography.

Figure 2 Diagnostic enhanced computer tomography scan (A), and un-enhanced computer tomography scan scans (B, C) performed during interventional procedure. A: Patient developed a pancreatic fistula and abdominal fluid collection after surgery for pancreatic neoplasm; B, C: Percutaneous approach, was then adopted: images show trans-gastric puncture (B) and the access and placement of 2 drains in the collection(C).

Figure 3 Prosthesis fully extended (Niti-S stent covered, TaeWoong Medical Co. , Seoul, South Korea) (A) and enhanced computer tomography scans (B, C) performed after interventional procedure. Images demonstrate prosthesis in situ and resolution of peripancreatic collections.

Figure 4 The external fistula opens on the skin surface (A), a catheter has been positioned through the fistula (B) and two prostheses have then been placed through these two guides (C).