PANCREATIC FISTULA AFTER PANCREATIC RESECTION: RISK AND MANAGEMENT

Aim of this study: Was to identify the risk factors and the outcome of management of pancreatic fistula after pancreatic resection. Methods: This prospective study included 65 consecutive pancreaticoduodenectomy performed for patients with pancreatic or periampullary tumors. Pancreatico-jejunal anastomosis was done by duct-tomucosa method in 57 patients and by dunking method in 8 patients. Postoperative evaluation included estimation of the drain output and its amylase content. Results: The patients were 34 (52.3%) males and 31 (47.7%) females. Nine patients (13.8%) developed fistula. There was statistically significant association between the development of pancreatic fistula and small caliber of pancreatic duct 3mm, soft pancreas, plasma albumin 3gm/dl and dunking anastomosis. Five patients recovered by conservative treatment alone. Three patients needed interventional radiology in addition to conservative treatment. Two patients died. Conclusion: Many risk factors of pancreatic fistula were identified. The majority of pancreatic fistulae could be treated successfully by conservative treatment alone or with interventional radiology