PANCREATIC FISTULA AFTER PANCREATIC RESECTION: RISK AND MANAGEMENT

Document Type : Original Article

Authors

Department of Surgery, Faculty of Medicine, Alexandria University

Abstract

Aim of this study: Was to identify the risk factors and the outcome of management of pancreatic fistula 
after pancreatic resection. 
Methods: This prospective study included 65 consecutive pancreaticoduodenectomy performed for 
patients with pancreatic or periampullary tumors. Pancreatico-jejunal anastomosis was done by duct-tomucosa method in 57 patients and by dunking method in 8 patients. Postoperative evaluation included 
estimation of the drain output and its amylase content. 
Results: The patients were 34 (52.3%) males and 31 (47.7%) females. Nine patients (13.8%) developed 
fistula. There was statistically significant association between the development of pancreatic fistula and 
small caliber of pancreatic duct <3mm, soft pancreas, plasma albumin < 3gm/dl and dunking anastomosis. 
Five patients recovered by conservative treatment alone. Three patients needed interventional radiology in 
addition to conservative treatment. Two patients died. 
Conclusion: Many risk factors of pancreatic fistula were identified. The majority of pancreatic fistulae 
could be treated successfully by conservative treatment alone or with interventional radiology. 

Keywords

The Egyptian Journal of Surgery
Volume 31, Issue 1
January 2012
Pages 24-29

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