A single-institution experience with fistulojejunostomy for external pancreatic fistulas

External pancreatic fistulas resistant to medical treatment ave an indicati on for surgery. Over the period from May 1986 to March 1999, we operated on 17 patients suffering from a stabilized external pancreatic fistula as a r esult of surgical treatment for severe acute pancreatitis in 12 cases, chro nic pancreatitis in 3, duodenopancreatectomy in 1, and islet cell tumor enu cleation in 1, The surgical repair consisted of precise identification of t he fistula tract around the drainage tube and its anastomosis with a Rouxen -Y jejunal loop (fistulojejunostomy). The surgical mortality was nil, and t he postoperative outcome was uneventful in 12 patients. Four patients exper ienced surgical complications, all of which were treated conservatively. Af ter a median follow-up of 93 months, 14 patients are still alive and health y, 1 had died of neoplastic cachexia, and 2 were lost to follow-up. In our experience, fistulojejunostomy appears to be safe, easy to perform, and cur ative. (C) 2000 by Excerpta Medica, Inc.