title: Role of fistulography in evaluating pancreatic fistula after pancreaticoduodenectomy.
abstract: OBJECTIVE
  To evaluate the usefulness of fistulography as a diagnostic and management tool for clinically suspected pancreatic fistulas (PF) after pancreaticoduodenectomy (PD).
  
  
  METHODS
  84 consecutive fistulographies were performed for clinical suspicion of PF and retrospectively analysed. We radiologically defined two types of PF by means of fistulography, PF1 in the case of primary filling with contrast agent of the jejunal loop or stomach and PF2 in the case of secondary filling of the jejunal loop or stomach through a fistulous tract or a fluid collection.
  
  
  RESULTS
  In 35/84 (41.7%) of the fistulograms, a PF1 was demonstrated owing to an instantaneous opacification of the intestinal lumen or the stomach, without evidence of a fistulous tract or fluid collection. In 49/84 (58.3%) fistulograms, a PF2 was demonstrated by the depiction of a fluid collection and/or a fistulous tract and a communication with the intestinal loop or the stomach anastomised with the pancreas. The mean healing time of a PF after PD was 2.7 days for PF1, and 9.8 days for PF2.
  
  
  CONCLUSIONS
  Fistulography helps in the confirmation of clinically suspect PF, and can distinguish PF1 and PF2, thus decreasing post-operative morbidity significantly.
authors.affiliation: Department of Radiology, G.B. Rossi Hospital, University of Verona, Verona, Italy. nfaccioli@sirm.org
authors.forename: N
authors.initials: N
authors.lastname: Faccioli
authors.forename: G
authors.initials: G
authors.lastname: Foti
authors.forename: E
authors.initials: E
authors.lastname: Molinari
authors.forename: J J
authors.initials: JJ
authors.lastname: Hermans
authors.forename: A
authors.initials: A
authors.lastname: Comai
authors.forename: G
authors.initials: G
authors.lastname: Talamini
authors.forename: C
authors.initials: C
authors.lastname: Bassi
authors.forename: R
authors.initials: R
authors.lastname: Pozzi-Mucelli
mesh_terms: D000328:Adult; D000368:Aged; D001658:Biliary Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D003287:Contrast Media; D005260:Female; D005747:Gastric Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D007579:Jejunal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media