[Pancreatic fistulae (author's transl)]

Area of Science:

• Gastroenterology and Surgical Oncology
• Pancreatic Surgery
• Fistula Management

Context:

• Increasing incidence of persistent external pancreatic fistulae post-inflammation or trauma.
• Challenges in surgical timing and technique for complex pancreatic fistulae.
• Review of 15 years of clinical experience and literature.

Purpose:

• To determine optimal timing for surgical closure of external pancreatic fistulae.
• To evaluate effective surgical techniques for managing pancreatic fistulae.
• To provide evidence-based recommendations for surgical intervention.

Summary:

• Recommends surgical closure of pancreatic fistulae within approximately six weeks to allow for granulation.
• Advocates for fistulo-jejunostomy with extensive fistula tract resection, particularly using the "pull through" technique.
• Suggests initial placement of drainage tubing along the gastrocolic ligament for advantageous subsequent fistula development.

Impact:

• Guides surgical decision-making for improved patient outcomes in pancreatic fistula management.
• Contributes to the understanding of optimal surgical strategies for complex pancreatic fistulae.
• Aims to reduce morbidity associated with persistent external pancreatic fistulae.