[Pancreatic fistula following duodenocephalopancreatectomy with Wirsung occlusion].
OBJECTIVE
The large number of operative procedures used to carry out an enteropancreatic anastomosis after pancreatoduodenectomy definitely mirror all difficulties and problems brought about by anastomosis. The aim of this study is to evaluate the clinical results and complications concerning the pancreatic remnant after pancreatoduodenectomy with Wirsung duct occlusion.


METHODS
From 1984 to 1999, 134 patients were treated by pancreatoduodenectomy with Wirsung duct occlusion using synthetic resins. A consecutive series of 95 patients without mortality operated in the last decade were regularly followed by ultrasound examination and CT-scan as well as by serial measurements of the volume and the amylase content of the drainage fluid.


RESULTS
No operative mortality occurred. Two events could be evidenced after this kind of operation: 1) the presence of an asymptomatic fluid collection at the side of the pancreatic section with spontaneous absorption (31 patients: 32.6%); 2) the occurrence of a pancreatic fistula (5 patients: 5.3%): in three cases (3.2%) a fistula jejunostomy was required.


CONCLUSIONS
The evidence of the mild clinical relevance of complications and the low percent rate of reoperations enables to state that this method can be highly reliable.
La Guardia
G
G
Chirurgia Generale 2, Ospedale Regionale di Bolzano.
Frena
A
A
Polato
R
R
Martin
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging; D010183:Pancreatic Ducts / Q000601:surgery*; D010185:Pancreatic Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D016577:Pancreaticoduodenectomy / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D013396:Suction; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography