2010 Volume 43 Issue 1 Pages 61-65
Intractable pancreatic fistula, especially if completely external, remains a critical complication after panceaticoduodenectomy, even though most such fistulas are cured by conservative therapy. Attempts at surgical correction are reported to be very difficult. We report a case of intractable external post-panceaticoduodenectomy pancreatic fistula successfully treated by interventional internal drainage. A 77-year-old woman underwent pancreaticoduodenectomy for an intraductal papillary mucinous neoplasm. After the stent tube inserted into the pancreatic duct was removed, pancreatic juice began being discharged from the drain. Fistulography showed no communication between the main pancreatic duct and the elevated jejunum, so we conducted puncture at the elevated jejunum through the sinus tract under X-ray to implement communication. About 3 months later, the drainage tube was removed and the fistula closed.
