Persistent pancreatocutaneous fistula after percutaneous drainage of pancreatic fluid collections: role of cause and severity of pancreatitis.
OBJECTIVE
To assess the relationship between the cause and severity of pancreatitis and the development of persistent pancreatocutaneous fistula (PPCF) after percutaneous drainage of pancreatic fluid collections.


METHODS
Sixty patients (44 male, 16 female; age range, 10-74 years) were included in the study. The cause of pancreatitis was postoperative in 29 patients, alcoholism in 20 patients, biliary in six patients, hyperlipidemia in two patients, unknown in two patients, and trauma in one patient. Patients requiring intensive care unit treatment for their condition at the time of drainage were considered to have severe pancreatitis. Thirty-seven patients had mild pancreatitis, and 23 had severe pancreatitis. PPCF was defined as catheter drainage of pancreatic fluid of more than 10 mL/d for more than 4 weeks after catheter placement.


RESULTS
PPCF developed in 27 of the 60 patients. It occurred in five of the six patients with biliary pancreatitis, 10 of the 20 with alcohol-related pancreatitis, and 10 of the 29 with postoperative pancreatitis (P > .2). The prevalence of PPCF was higher in patients with severe pancreatitis (n = 16 [70%]) than in those with mild pancreatitis (n = 11 [30%]). This difference was statistically significant (P < .002).


CONCLUSIONS
Development of PPCF correlated with severity of pancreatitis, regardless of the cause of pancreatitis.
Fotoohi
M
M
Department of Radiology (C5-XR), Virginia Mason Medical Center, Seattle, WA 98101, USA. radm1f@ix.netcom.com
D'Agostino
H B
HB
Wollman
B
B
Chon
K
K
Shahrokni
S
S
vanSonnenberg
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001826:Body Fluids; D002648:Child; D017577:Cutaneous Fistula / Q000209:etiology*; D004322:Drainage; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications / Q000209:etiology* / Q000628:therapy; D010195:Pancreatitis / Q000150:complications* / Q000209:etiology; D012720:Severity of Illness Index