2020 Volume 69 Issue 2 Pages 87-92
We experienced a case of intractable pancreatic fistula after pancreatoduodenectomy, successfully cured by fistulo-jejunostomy directly under the abdominal wall. A 56-year-old woman underwent pancreatoduodenectomy for carcinoma of pancreatic head. After removal of the drainage tube of anastomosis of pancreato-jejunostomy, pancreatic juice started to discharge from the median wound. Conservative therapy such as fasting, TPN, and administration of somatostatin analogue failed to achieve complete healing of pancreatic fistula. The patient underwent surgical treatment 64 days after pancreatoduodenectomy. At laparotomy, fistulo-jejunostomy was performed directly under the abdominal wall. A splint tube was inserted into the anastomosed site and the jejunum and abdominal wall were sutured for fixation, and drainage was made externally via the splint tube. Postoperative course was uneventful and she had no recurrence of pancreatic fistula until now. This surgical procedure is easily and safety and make a certain fixation of jejunum to fistula, so it might be a useful treatment of intractable pancreatic fistula after pancreatoduodenectomy. Because long-term results of its procedure is unknown, further consideration should be needed after collecting cases.
