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A new nonoperative method of percutaneous transgastric fistulo-drainage for an intractable external pancreatic fistula —A case report—

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Abstract

The external pancreatic fistula is a well-known complication of pancreatectomy and is conventionally classified as either a partial fistula or a total fistula. A partial fistula usually closes spontaneously and operative intervention is rarely needed, whereas, a total fistula on the other hand, very often, does not close and may therefore require surgical intervention. We report herein, a case of an intractable total pancreatic fistula following pancreatoduodenectomy which was successfully repaired by a new nonoperative method of percutaneous transgastric fistulo-drainage (PTFD). This technique, performed under the control of a two-way X-ray television system, is safe and considered useful for the treatment of an intractable total pancreatic fistula. In the future, this may be the method of choice for the management of such refractory total pancreatic fistulae.

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References

  1. Papachristou DN, Fortner JC. Pancreatic fistula complicating pancreatectomy for malignant disease. Br J Surg 1981; 68; 238–240.

    PubMed  CAS  Google Scholar 

  2. Aston SJ, Longmire WP. Management of the pancreas after pancreaticoduodenectomy for malignant disease. Ann Surg 1974; 179: 322–327.

    PubMed  CAS  Google Scholar 

  3. de Boid MHW, Bosman CHR, de Graaf P, Van Hoogenhuijze J. Closure of a high-output external pancreatic fistula by SMS 201-995, a long-acting analogue of somatostatin. Neth J Med 1988; 32: 293–297.

    Google Scholar 

  4. Zinner MJ, Baker RR, Cameron JL. Pancreatic cutaneous fistulas. Surg Gynecol Obstet 1974; 138: 710–712.

    PubMed  CAS  Google Scholar 

  5. Traverso LW, Longmire WP. Preservation of the pylorus in pancreaticoduodenectomy. Surg Gynecol Obstet 1978; 146: 959–962.

    PubMed  CAS  Google Scholar 

  6. Nagakawa T. Improvement technique for pancreaticojejunostomy after extended pancreaticoduodenctomy. Nippon Rinsho Geka Gakkai Zasshi (J Jpn Soc Clin Surg) 1983; 44: 1000–1003. (in Japanese)

    Google Scholar 

  7. Nagakawa T, Asano E, Higashino N, Sakuma H, Taki K, Takada M, Ueno K, Konishi I, Shinmura K, Iumi R, Konishi K, Kurachi M, Miyazaki I. Percutaneous transhepatic choledochal drainage under the control of 2-way roentgen-television system. Nippon Rinsho Geka Gakkai Zasshi (J Jpn Soc Clin Surg) 1983; 44: 149–152. (in Japanese)

    Google Scholar 

  8. Arvanitakis C, Greenberger NJ. Diagnosis of pancreatic disease by a synthetic peptide. A new test of exocrine pancreatic function. Lancet 1967; 1: 663–667.

    Google Scholar 

  9. Hosoda S, Nakaki T, Kinugasa K, Kashima K, Banba T, Nakajo S, Masuda M. Pancreatic exocrine function test using pancreatic function diagnostant (PFD). A new test of exocrine pancreatic function. J Kyoto Pref Univ Med 1979; 88: 729–733.

    CAS  Google Scholar 

  10. Ponsky JL, Gauderer MWL. Percutaneous endoscopic gastrostomy: Indications, limitations, techniques, and results. World J Surg 1989; 13: 165–170.

    Article  PubMed  CAS  Google Scholar 

  11. Jordan GL. Pancreatic fistula. Am J Surg 1970; 119: 200–204.

    Article  PubMed  Google Scholar 

  12. Fujita H, Konishi K, Izumi H, Miwa K, Miyazaki I. Pathophysiology and management of pancreatic fistula. Shokaki Geka (Gastroenterol Surg) 1980; 3: 1495–1501. (in Japanese).

    Google Scholar 

  13. Pederzoli P, Bassi C, Falconi M, Albrigo R, Vantini I, Micciolo R. Conservative treatment of external pancreatic fistulas with parenteral nutrition alone or in combination with continuous intravenous infusion of somatostatin, glucagon or calcitonin. Surg Gynecol Obstet 1986; 163: 428–432.

    PubMed  CAS  Google Scholar 

  14. Janes RM. Pancreatic fistula. Report of a case; cure by pancreatogastrostomy. Br J Surg 1935; 22: 296–300.

    Google Scholar 

  15. Lahey FH, Lium R: Cure of pancreatic fistula by pancreatojejunostomy. Surg Gynecol Obstet 1937; 64: 79–88.

    Google Scholar 

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Ohta, T., Nagakawa, T., Tsukioka, Y. et al. A new nonoperative method of percutaneous transgastric fistulo-drainage for an intractable external pancreatic fistula —A case report—. The Japanese Journal of Surgery 21, 229–233 (1991). https://doi.org/10.1007/BF02470914

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  • DOI: https://doi.org/10.1007/BF02470914

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