Disrupted Pancreatic Duct Syndrome: An Evolving Challenge that Calls for Innovative Approach

Subsequent CT scans confirmed a DPD with a large gap between the head and tail of the pancreas (Fig. 2 B) from the necrosectomy. Because of the large gap, the patient was not a good candidate for bridging stent placement, but a stent was placed with the distal tip projecting into the gap. On a follow-up CT scan 18 months after his index surgery, the fistula has resolved into a fibrotic tunnel connecting the head of the pancreas to its tail (Fig. 2 C). [...]although several previous publications recommend placing an ERCP stent completely across the disrupted area when treating DPDS, we present two patients who underwent successful treatment by ERCP stent without bridging the disrupted area.