Clinical analysis of pancreatic fistula after pancreaticoduodenectomy

Objective To summarize the experience and to lower operative morbidity through analyzing the cases of pancreatic fistula after pancreaticoduodenectomy from Jan. 1986 to Juen 2001. Methods Data of 62 cases of pancreaticoduodenectomy from Jan. 1986 to June 2001 were retrospectively analyzed. Results Of the 62 cases undergoing pancreaticoduodenectomy, pancreatic fistula occurred in 9 cases with a morbidity rate of 14. 5%. In 5 of the 8 cases (62. 5%). Pancreatic fistula occurred between Jan. 1986 and Dec. 1991, and in 6 of the remaining 54 cases (7. 4%) between Jan. 1992 and June 2001. Two patients (3. 2%) died in perioperation because of pancreatis fistula leading to systemic failure. The overall morbidity of pancrteatic fistula was 22.2%. Conclusions To lower the morbidity of pancreatic fistula, the key lies in improving the operative skill and mode in addtion to pre- and postoperative supporting therapy, use of somatostatin, control of infection and effective gastrointestinal decompression. Most pancreatic fistulas can be cured by early diagnosis and combined therapy.