Transgastric pancreatic duct drain

Chronic pancreaticocutaneous fistulas can be difficult to treat.  This paper presents a snare-target technique for draining a non-dilated pancreatic duct into the stomach, thus diverting pancreatic fluid away from the pancreaticocutaneous fistula to allow it to heal.  Internal or internal/external transgastric pancreatic duct or fistula drains were placed in 6 patients.  After an average of 4 months of drainage, all 6 patients had resolution of the cutaneous fistula.  2 patients developed a pseudocyst but no recurrent fistula after drain removal, and the other 4 had no pseudocyst or fistula after an average of 27 months follow up (range 6-74 months).