A Case of Intractable External Pancreatic Fistula following Pancreaticoduodenectomy Successfully Cured by Inter Ventional Drainage

Masatsune Shibutani, Hitoshi Teraoka, Shigetomi Nakao, Yutaka Tamamori and Atsunori Nitta

Department of Surgery, Baba Memorial Hospital

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.

Key words
pancreaticoduodenectomy, pancreatic fistula, interventional internal drainage

Reprint requests
Masatsune Shibutani Department of Surgery, Baba Memorial Hospital
4-244 Hamaderafunaomachihigashi, Nishi-ku, Sakai, 592-8555 JAPAN

Accepted
May 27, 2009

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