Abstract No. 526 Percutaneous Fistulogastrostomy for the Treatment of Pancreaticocutaneous Fistulae

To evaluate the role of Percutaneous fistulogastrostomy for the treatment of pancreaticocutaneous fistulae. Between Jan 2016 and July 2023, 16 patients were referred to interventional radiology, who despite conservative management, had persistently high output through drains placed for necrotizing pancreatitis with resultant pancreaticocutaneous fistulae (PCF). This study was approved by the institutional review board. The communication between the fistula and stomach was established either via anterior/posterior or EUS-guided approach. A fabricated "double" Malecot design was chosen for the purposes of stenting as the traditionally available pigtail/plastic stents would require more space to conform to their shape and inability to do so in the fistula could predispose to early migration. Sixteen patients underwent a fistulogastrostomy during the study period of which 14 underwent a single-step procedure, and 2 underwent a two-step procedure. An anterior approach was performed in 11 patients, posterior approach in 3, and EUS-assisted approach in 2 patients respectively. Fabricated 12 French polyurethane "double" Malecot stents were placed in these patients. No intraprocedure or early post procedure complication was noted. One patient developed persistent pus discharge from the drain site requiring surgical intervention at 1 month. The management of PCF can be challenging and the procedure of percutaneous fistulogastrostomy, significantly reducing the drainage catheter indwelling time.