Evidence-Based Medicine
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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2020; 26(37): 5718-5730
Published online Oct 7, 2020. doi: 10.3748/wjg.v26.i37.5718
Table 1 Laboratory findings in patients with pancreaticopleural fistula
Patients Appearance of pleural effusion Leukocyte count of pleural fluid (× 106 L) Pleural effusion protein (g/L) Pleural amylase (U/L) Serum amylase (U/L) Blood lipase (U/L) Ascites amylase (U/L) 1 Bloody 300 40.0 6625 1026 3912.9 13053.0 2 Bloody 560 34.0 10477 423 1051 - 3 Bloody 3600 40 3178 409 950 - 4 Bloody 1700 17.4 50465 284-654 355.4 - 5 Bloody 800 45 1584 110 4470 - 6 Bloody 1200 27.6 65000 1368 1312.2 7 Bloody 6 46.7 25549 738 731.2 -
Table 2 Clinical symptoms, treatments, and outcomes of seven children with pancreaticopleural fistula
Patients 1 2 3 4 5 6 7 Age (yr) 8 10 3 2 5 8 10 Gender Male Female Male Male Female Female Female Symptom Fatigue, poor appetite, intermittent fever, abdominal distention Intermittent chest tightness and upper abdominal pain Chronic pancreatitis, recurrent abdominal pain Wheezing, shortness of breath, repeated bloody pleural effusion Abdominal pain for half a year, fever and chest tightness Intermittent chest tightness and dyspnea for more than 20 d Chest pain with dyspnea Etiology Suspected trauma and pseudocyst Dilatation and calculus of pancreatic duct Congenital pancreatic duct dysplasia and pseudocyst Pseudocyst and dilatation of pancreatic duct Pseudocyst and dilatation of pancreatic duct Dilatation and calculus of pancreatic duct Pancreatic duct stone, pseudocyst, dilatation of pancreatic duct Diagnosis laboratory examination, B ultrasound, MRCP laboratory examination, MRCP laboratory examination, enhanced CT, MRC, ERCP laboratory examination, CT, B ultrasound, MRCP laboratory examination, CT, B ultrasound, MRCP laboratory examination, CT, MRCP, ERCP laboratory examination, CT, B ultrasound, MRCP Location of pleural effusion Right Bilateral Bilateral Left Right Bilateral Right Amylase in pleural effusion (U/L) 6625 10477 3178 50465 1584 65000 25549 Conservative treatment time (d) 10 21 60 24 19 20 10 ERCP treatment Yes (Surgical treatment after ERCP failure) No (Operation) Yes Yes No (Operation) Yes Yes Serum amylase concentration before operation (U/L) 889.4 153 367 429 93.0 292 283 Serum amylase concentration after operation (U/L) 102 267 315 105 110 Time for amylase to return to normal (Days after operation) 23 10 9 4 Lipase concentration before operation/ERCP (U/L) 567 1051 355.4 115 106 731.2 Lipase concentration after operation/ERCP (U/L) 51.7 62.4 Stop somatostatin pump maintenance time (days after operation) 19 5 3 4 Postoperative recovery time of eating (days after operation) 3 3 6 6 4 15 Times of fever treated conservatively 1 3 5 3 4 Normal temperature Chest closed drainage time (days after operation) - - 16 - - - Postoperative hospital stay (d) 20 30 30 12 12 23 Total length of stay (d) 30 52 90 36 32 33
Table 3 Comparison of therapeutic effect of endoscopic retrograde cholangiopancreatography vs conservative treatment
Patients Conservative treatment time (d) Recovery time of indexes after ERCP (d) Serum amylase concentration (U/L) Hospital stay after different treatment (d) Total length of stay (d) Postoperative discharge Somatostatin pump maintenance Recovery time of eating Blood amylase recovery 2 d before operation 2 d after operation Operation ERCP 12 10 20 30 22 21 31 52 52 19 - 33 60 30 19 6 23 367 292 30 90 43 24 12 5 6 10 267 249 12 36 63 20 12 3 4 9 429 283 12 32 71, 3 10 23 4 15 4 315 110- 23 33 Average (ERCP) 34.67 ± 22.03 18 ± 10.39 9 ± 8.72 5.33 ± 1.15 14 ± 7.81 344.5 ± 69.58 233.5 ± 84.39 25.5 ± 7.78 18 ± 10.39 -
Table 4 Worldwide cases of pancreaticopleural fistula published in the most recent 10 years
Publication years Gender/age (yr) Diagnosis Treatments Conservative treatment time (d) Postoperative hospital stays (d) Operation ERCP Adult 2009[6 ] F/52 CT/MRCP Conservative/ERCP 14 7 2009[6 ] M/46 MRCP Conservative/ERCP 27 14 2010[7 ] F/44 CT Conservative/operation 5 2012[8 ] M/64 B ultrasound/ERCP Conservative/ERCP 2012[9 ] F/52 CT Conservative/operation 2012[10 ] M/58 CT/ERCP Conservative/operation 42 2013[11 ] F/47 CT Conservative 2013[12 ] M/59 CT/ERCP Conservative 56 2013[13 ] F/58 CT/MRI Conservative/ERCP 7 12 2016[14 ] F/65 CT/MRCP Conservative/operation 21 2014[15 ] F/50 CT/MRCP Conservative/ERCP/operation 2014[16 ] M/49 CT/MRCP/MRI Conservative/operation 2015[17 ] M/43 CT/ERCP Conservative/operation 35 10 2015[18 ] M/43 CT/MRCP Conservative/ERCP/operation 28 2016[19 ] M/58 CT Conservative/ERCP 2016[20 ] M/51 CT/ERCP/MRI ERCP 21 2016[21 ] F/51 CT/MRCP Conservative/operation 28 5 2016[22 ] F/63 CT/MRCP Conservative/operation 30 2016[23 ] M/78 CT Conservative 2017[24 ] M/44 MRCP Conservative/ERCP 2017[25 ] M/52 CT/MRCP Conservative 2018[26 ] M/49 CT/MRCP/ERCP Conservative/ERCP 2019[27 ] M/52 Operation Conservative/ERCP 21 2019[28 ] M/35 CT Conservative/ERCP 14 20 2019[29 ] M/65 CT/MRCP/ERCP Conservative/operation Children 2009[30 ] M/4 CT/MRCP Conservative/ERCP 60 30 2013[31 ] F/5 CT Conservative 50 2013[32 ] M/15 CT/MRI Conservative/ERCP 28 2014[33 ] M/2.5 B ultrasound/CT Conservative/operation 26 11 2014[34 ] M/8 CT Conservative 60 2014[34 ] M/2 CT Conservative 2016[35 ] M/2 CT operation 2018[36 ] F/8 CT/MRCP Conservative/ERCP 17 19 2018[37 ] F/14 CT/MRCP Conservative/operation 30 2019[38 ] M/3 CT/MRCP Conservative/ERCP 18 2019[39 ] F/8 CT/MRCP Conservative/ERCP 8 18 2019[40 ] M/14 CT Conservative/operation 30 AVG 30.76 ± 17.4 16 ± 10.95 18.7 ± 6.88 P valueP > 0.05