gms | German Medical Science

130. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

30.04. - 03.05.2013, München

Treatment of symptomatic pancreatic fistula by continuous irrigation and drainage via percutaneous drainage of the pancreatic remnant – simple and feasible alternative to total pancreatectomy

Meeting Abstract

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  • Georg Wiltberger - Uniklinik Leipzig, Chirurgie, Leipzig

Deutsche Gesellschaft für Chirurgie. 130. Kongress der Deutschen Gesellschaft für Chirurgie. München, 30.04.-03.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13dgch256

doi: 10.3205/13dgch256, urn:nbn:de:0183-13dgch2561

Veröffentlicht: 26. April 2013

© 2013 Wiltberger.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Introduction: Symptomatic pancreatic fistulas occur in 5-30% after pancreaticoduodenectomy and remain a threatening complication. Several surgical approaches have been proposed including total pancreatectomy associated with severe morbidity and high mortality. We report our results of preservation of a pancreatic remnant combined with continuous irrigation and drainage via percutaneous tubes as a simple and feasible alternative.

Material and methods: Between 2005 and 2011 thirteen patients suffered from symptomatic pancreatic fistula and required reoperation. Pancreaticojejunal anastomosis was disconnected and at least three catheters for continuous irrigation and drainage were placed close to the pancreatic remnant. Regular follow-up was performed and Quality of life (QoL) was evaluated with questionnaire EORTC QLQ-C30. Students t test was performed for quantitative analysis.

Results: Pancreaticoduodenectomy was performed in 202 patients with a median age of 64 (range 89-35).Thirteen patients (5.9%) with a median age of 69 (range 52-75) required a reoperation with continuous irrigation and drainage due to symptomatic fistula with a median operation time of 80 min (range 53-230). The 90 day- and in-hospital-mortality rate was 15.3%. These two patients died due to acute myocardial infarction and multi-organ-failure, respectively. Median length of stay at intensive care unit (LOS-ICU) and total length of stay (T-LOS) of the surviving patients was 18 days (range 3-45) and 46 days (range 33-96), respectively. Four patients had a stable pancreatic fistula at discharge which disappeared after a mean time of 43 days (range 28-60). Patient with early reoperation (< 10 days) had significantly decreased LOS-ICU and operation time. One patient developed postoperative diabetes. Global health status was nearly identical when compared to healthy control group. Median survival was 19 months (range 5-66).

Conclusion: Treatment of pancreatic fistula by continuous irrigation and suction of the preserved pancreatic remnant is a simple and feasible approach associated with a low mortality and a fair QoL maintaining sufficient endocrine function by avoiding total pancreatectomy.