2010 Volume 71 Issue 1 Pages 196-200
An external pancreatic fistula occurring after pancreaticoduodenectomy may become intracTable and difficult to treat. We report here a case in which interventional internal drainage was successfully used to treat a complete external pancreatic fistula following pancreaticoduodenectomy.
The patient was an 80-year-old woman. Pancreaticoduodenectomy was performed to treat duodenal papillary carcinoma. Following the surgery, an intraperitoneal abscess developed as a result of rupture of the sutures of the pancreatojejunal anastomosis. The abscess cavity was converted to a fistula when internal drainage and other conservative treatment was performed, and a complete external pancreatic fistula was diagnosed by fistulography. Since imaging showed that the fistula and the jejunum were adjacent to each other, an internal drainage catheter was inserted into the jejunum from the pancreatic fistula under fluoroscopy and ultrasound observation ; it was placed within the jejunum to provide internal drainage. The patient's postoperative course was uneventful, and today, 13 months after undergoing internal drainage, the patient has no symptoms of pancreatitis or glucose tolerance abnormalities and is continuing to do well.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
