2020 Volume 62 Issue 9 Pages 1592-1599
A 75-year-old woman was admitted to our hospital because of obstructive jaundice and was diagnosed with perihilar cholangiocarcinoma by endoscopic retrograde cholangiopancreatography (ERCP). After the procedure, severe acute pancreatitis associated with walled-off pancreatic/peripancreatic necrosis (WON) occurred. Although we performed endoscopic ultrasound and percutaneous drainage, it was difficult to control the infection. Additionally, a fistula between the WON and sigmoid colon was found. Therefore, we planned to perform endoscopic closure of the fistula using an over-the-scope clip (OTSC) system as a minimally invasive therapy. We succeeded in closing the pancreatico-colonic fistula, and the WON disappeared. A pancreatico-colonic fistula caused by acute pancreatitis, is a rare but difficult complication to resolve. We found that fistula closure using the OTSC system could be an effective treatment, especially for patients in generally poor condition.
