Diagnosis and surgical treatment of chronic pancreatic external fistulas

We conducted the results of surgical treatment of 18 patients with chronic external pancreatic fistulas (PF). Patient population included 2 females and 16 males. Mean age was 38 (from 18 to 52). The development of PF in 9 cases (50%) was the result of severe destructive pancreatitis, in 6 - abdominal trauma (33,3%) and in 3 (16,6%) cases we had postoperative pancreatic fistula. Pancreatojejunoanastomosis (PJA), cystodigestive anastomosis (CDA), distal pancreatic resection were used to treat PS. The original method end -to-end distal PJA with Roux loop was performed in 10 cases of pancreatic leakage from major pancreatic duct. Four patients with preserving back part of pancreas and dilated major pancreatic duct were submitted to longitudinal PJA with Roux loop of small intestine. Pancreatic distal resection and splenectomy were made in 2 cases, cystogastroanastomosis - also twice, when PS was transformed into cyst. Postoperative morbidity was 27,7% (5). Two patients (11,1%) had the recurrence PS. Conservative treatment was successful in treatment of all complications. No postoperative death occurred.