Treatment and Prognosis for Pancreatic Duct Disruption Associated with Pancreatic Cancer: a case series of 16 patients

Abstract

Abstract Pancreatic duct (PD) disruption can be attributed to pancreatic cancer. This study investigated the therapeutic modalities and prognostic implications of PD disruption in pancreatic cancer. This retrospective study included 16 patients with PD disruption concomitant with pancreatic cancer between April 2011 and March 2023. Of the 16 cases of PD disruption, 12, nine, and two included pseudocysts, infected cysts, and walled–off necrosis, respectively. Five patients underwent endoscopic pancreatic stenting, nine were managed endoscopic ultrasonography-guided pancreatic fluid collection drainage, and two were treated with lumen-apposing metal stent placement. All patients achieved both technical and clinical success without complications. The clinical stage of pancreatic cancer spanned from carcinoma in situ to the metastatic phase. For the treatment of pancreatic cancer, six patients underwent surgical resection, and eight underwent chemotherapy. No cases of peritoneal dissemination were observed. The median overall survival from the diagnosis of pancreatic cancer in the resected and non-resected cases was 2222 and 289 days, respectively. Endoscopic intervention was effective in all cases of PD disruption due to pancreatic cancer. Furthermore, even in cases of pancreatic cancer after PD disruption, survival rates were similar to those in cases without PD disruption and were achieved through surgical resection or chemotherapy.