Postoperative Pancreatic Leaks and Fistulae: The Role of the Endoscopist

Iatrogenic pancreatic injury, leakage, and fistulae formation are well-documented complications of surgery of the pancreas and peri-pancreatic area. Postoperative pancreatic duct leaks and fistulae can lead to significant morbidity and mortality, hence achieving closure of ductal defects and fistulae is of great importance. Successful management requires a multidisciplinary team approach incorporating pancreaticobiliary endoscopists, pancreatic surgeons, and interventional radiologists. The approach to the patient depends on the nature and extent of ductal injury, the presence or absence of pseudocysts, and endoscopic access to the pancreatic duct. This review will focus on the role of the endoscopist in the management of pancreatic fistulae.