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Salvage anastomosis for postoperative chronic pancreatic fistula

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Abstract

Salvage anastomosis for postoperative chronic pancreatic fistula is challenging, and its safety and surgical outcomes remain unclear. Four patients with postoperative chronic pancreatic fistulas who underwent surgical interventions in our institute were retrospectively reviewed. A re-pancreatojejunostomy was performed in two patients with a disruption of the pancreatojejunostomy and a dilated main pancreatic duct of the remnant pancreas. A fistulojejunostomy was performed in the remaining two patients with a duct disruption after necrosectomy for necrotic severe acute pancreatitis and non-dilated main pancreatic duct. The median duration from the onset of the pancreatic fistula to the surgical intervention was 4.5 months (range 4–6 months). The median operation time was 151 min (range 38–257 min) and the median blood loss was 200 mL (range 5–350 mL). According to the Clavien–Dindo classification, one patient had grade 0, two patients had grade I, and one patient had grade II (wound infections). The median length of hospital stay was 22 days (range 21–28 days). There were no recurrences of pancreatic fistulas. Salvage anastomosis according to the simple radiologic classification for postoperative chronic pancreatic fistulas is a safe and effective procedure.

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Authors and Affiliations

  1. Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan

    Shoji Kawakatsu, Yuji Kaneoka, Atsuyuki Maeda & Yasuyuki Fukami

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  1. Shoji Kawakatsu
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  2. Yuji Kaneoka
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  3. Atsuyuki Maeda
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  4. Yasuyuki Fukami
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Correspondence to Yasuyuki Fukami.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kawakatsu, S., Kaneoka, Y., Maeda, A. et al. Salvage anastomosis for postoperative chronic pancreatic fistula. Updates Surg 68, 413–417 (2016). https://doi.org/10.1007/s13304-016-0383-y

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  • DOI: https://doi.org/10.1007/s13304-016-0383-y

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