A Case of Intractable Pancreatic Fistula After Pancreaticoduodenectomy Successfully Cured by Interventional Internal Drainage

Fumihiro Taniguchi, Ichiro Aikawa, Tetsuro Matsuda and Tomohiro Tsuda

Department of Surgery, Soseikai General Hospital

External pancreatic fistula remains a critical complication after pancreaticoduodenectomy. We report a case of intractable pancreatic fistula after pancreaticoduodenectomy successfully treated by interventional internal drainage. A 73-years-old woman underwent pylorus-preserving pancreaticoduodenectomy for bile duct carcinoma. Pancreatic juice started descharging from drains on postoperative day 7, but halted and the fistula healed spontaneously, upon which the woman was discharged. Two months later, her pancreatic fistula relapsed and she was readmitted. Fistulography showed no communication between the main pancreatic duct and jejunum. Reoperation was considered. Canulation into the jejunal lumen on the opposite site was accomplished and an endoprosthesis was placed to connect the main pancreatic duct and jejunal lumen. The course after internal drainage was good, and she was discharged 4 weeks after internal drainage. She remains well and able to proceed with daily activity at the last follow-up, 1 year and 5 months later.

Key words
pancreatic fistula, interventional internal drainage, pancreaticoduodenectomy

Reprint requests
Fumihiro Taniguchi Department of Surgery, Soseikai General Hospital 1 Hiroosacho, Shimotoba, Fushimiku, Kyoto, 612-8473 JAPAN

Accepted
September 19, 2001

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