title: [Transcholedochal pancreatic fistula].
abstract: Pancreatic fistula is usually caused by acute or chronic pancreatitis, injury and operations of the pancreas. The pancreatic juice comes either from the main pancreatic duct or from side branches. Extremely rare pancreatic fistula may come through the distal end of the common bile duct that is not properly sutured or ligated after traumatic or operative transsection. We present a 58-year old man who developed a life threatening high output pancreatic fistula through the distal end of the common bile duct that was simply ligated after resection for carcinoma. Pancreatic fistula was developed two weeks after original surgery and after two emergency reoperations for serious bleeding from the stump of the right gastric artery resected and ligated during radical lymphadenectomy. The patient was treated conservatively by elevation of the drainage bag after firm tunnel round the drain was formed so that there was no danger of spillage of the pancreatic juice within abdomen.
authors.affiliation: Institute of Digestive Diseases, Clinical Centre of Serbia, Belgrade.
authors.forename: Radoje
authors.initials: R
authors.lastname: Colovićc
authors.forename: Nikica
authors.initials: N
authors.lastname: Grubor
authors.forename: Vesna
authors.initials: V
authors.lastname: Masirević
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Ivić
mesh_terms: D001658:Biliary Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D003135:Common Bile Duct / Q000601:surgery; D003137:Common Bile Duct Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation