title: Surgical management of pancreaticocutaneous fistula.
abstract: Although enteric drainage of the fistula tract is a widely accepted treatment for pancreaticocutaneous fistula, few data have been published on the outcome of this procedure. We conducted a retrospective chart review of 30 patients with pancreaticocutaneous fistula who underwent surgical management at a single institution over a 13-year period. The operative morbidity rate was 30%. Overall the incidence of recurrent ductal leaks requiring further intervention was 23%. Six of seven patients who had a recurrence had an ongoing inflammatory pathology, and three of seven had pancreas divisum. Recurrence was most likely when cystenterostomy was used. Enteric drainage of pancreaticocutaneous fistulas is not always curative. Fistulojejunostomy gives a better outcome than cystenterostomy. Recurrence may be expected in patients with continuing inflammatory ductal pathology.
authors.affiliation: Division of Surgery, Duke University Medical Center, Box 3110, 27710, Durham, NC.
authors.forename: Miranda
authors.initials: M
authors.lastname: Voss
authors.affiliation: Division of Surgery, Duke University Medical Center, Box 3110, 27710, Durham, NC.
authors.forename: Amjad
authors.initials: A
authors.lastname: Ali
authors.affiliation: Division of Surgery, Duke University Medical Center, Box 3110, 27710, Durham, NC.
authors.forename: W Steve
authors.initials: WS
authors.lastname: Eubanks
authors.affiliation: Division of Surgery, Duke University Medical Center, Box 3110, 27710, Durham, NC.
authors.forename: Theodore N
authors.initials: TN
authors.lastname: Pappas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities; D010185:Pancreatic Fistula / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies