title: Delayed pancreatic fistula after pancreaticoduodenectomy. A case report.
abstract: BACKGROUND
  Pancreatic fistulas still occur despite refinements in both surgical technique and perioperative management after a pancreaticoduodenectomy. However, the occurrence of delayed pancreatic fistulas is very rare.
  
  
  METHODS
  A 62-year-old woman diagnosed with a lower biliary carcinoma had undergone a pylorus-preserving pancreaticoduodenectomy. The postoperative course was uneventful and the patient was discharged from the hospital after 16 days. One year after surgery, she was admitted to our hospital with a fluid collection around the pancreaticojejunal anastomosis. A catheter was inserted percutaneously and the fluid collection was drained. The amylase value of the discharge was significantly elevated (119,500 IU/L). One week later, a fistulography showed no significant collection and the tube was clamped. The patient was discharged from the hospital without symptoms.
  
  
  CONCLUSIONS
  It is important to consider the occurrence of a delayed pancreatic fistula if the patient suffers from any symptoms. It is then necessary to proceed rapidly.
authors: Department of Surgery, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan. yasuito@ca3.so-net.ne.jp
authors: Yasuhiro
authors: Y
authors: Ito
authors: Tomoyuki
authors: T
authors: Irino
authors: Tomohisa
authors: T
authors: Egawa
authors: Shinobu
authors: S
authors: Hayashi
authors: Atsushi
authors: A
authors: Nagashima
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D001661:Biliary Tract Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed