Coincidence of pancreatic and biliary leakages after pancreaticoduodenal resections.
OBJECTIVE
Pancreaticoenteric leakage is the most important complication after pancreaticoduodenal resection. Bilioenteric leakage, though rarer, may also complicate recovery after pancreaticoduodenal resection. Each of these complications may occur separately or simultaneously and may be treated conservatively or need reoperation. The possible coincidence of these complications has not been studied.


METHODS
The case history of 46 patients, who underwent pancreaticoduodenal resection during 1991-1994 at Tampere University Hospital, Finland, was studied retrospectively.


RESULTS
Pancreatic fistula occurred in eight patients (17%) and biliary fistula in four (9%). Biliary fistula was more common in the patients with simultaneous pancreatic fistula than in those without, which was also noted when only clinical fistulas were considered. The three patients with both fistulas had soft tissue in the pancreatic resection line, which is more often than those without fistulas. Two of the three patients who were reoperated had pancreatitis at the reoperation.


CONCLUSIONS
Biliary leakage after pancreaticoduodenal resection occurs usually together with pancreatic leakage. One important cause for those leakages might be postoperative pancreatitis.
Department of Surgery, Tampere University Hospital and Medical School, University of Tampere, Finland.
M C
MC
Parviainen
J A
JA
Sand
I H
IH
Nordback
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001660:Biliary Tract Diseases / Q000209:etiology; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D005260:Female; D005402:Fistula / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000209:etiology; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010195:Pancreatitis / Q000209:etiology; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies