PANCREATIC FISTULA AFTER PANCREATICODUODENECTOMY - A COMPARISON BETWEEN PATIENTS WITH PERIAMPULLARY TUMORS AND CHRONIC-PANCREATITIS

BACKGROUND/AIMS: Whether the frequency of anastomotic leak after pancr eaticoduodenectomy for benign diseases is greater than for malignant c onditions and whether fistula development is associated with surgical mortality remains controversial. The purpose of this study is to compa re the incidence of anastomotic leak in patients operated on for chron ic pancreatitis and periampullary tumors. METHODOLOGY: The authors ret rospectively reviewed the charts of 67 patients (46 males, 21 females, mean age 47 years) submitted to pancreaticoduodenectomy for chronic p ancreatitis and periampullary tumors between 1990 and 1996. RESULTS: I n 44 patients with periampullary cancers, pancreatic fistula developed in 13 (29%) cases, and in 6 (26%) of the 23 patients with chronic pan creatitis (p > 0.05). Of the 19 patients who developed this complicati on, 5 (26.3%) died, and in the remaining 48 cases, there was only one (2.1%) death (p < 0.05). CONCLUSION: The frequency of pancreatic fistu la after pancreaticoduodenectomy in patients with periampullary tumors and chronic pancreatitis is not different, but the presence of a fist ula is strongly involved in postoperative mortality.