Percutaneous treatment of a pancreatic fistula after pancreaticoduodenectomy

Breakdown of the pancreaticojejunal anastomosis after a Whipple procedure i s reported to occur in as many as 15% of cases. Intraoperative placement of a drain adjacent to the anastomosis is performed to allow the creation of a controlled pancreaticocutaneous fistula in the event of an anastomotic di sruption. The authors present a case of successful percutaneous treatment o f a disrupted pancreaticojejunal anastomosis. This was achieved with use of the resulting pancreaticocutaneous fistula for access to restore internal drainage, followed by fistula occlusion with use of gelatin pledgets.