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Abstract:
The incidence of postoperative persistent external fistulae following inflammatory or traumatic lesions of the pancreas has increased over the past years. The choice of the optimum time for surgical rectification of this condition, as well as the operative technique is discussed in this review of the literature and 11 cases treated under our care over the past 15 years. It appears advisable 1) not to wait longer than about 6 weeks to carry out operative closure of the fistula (this period of time being necessary for the fistula to develop by granulation), 2) to undertake fistulo-jejunostomy with long section of the canal of the fistula, if possible, especially when applying the "pull through" method and 3) to place, if possible, the drainage tubing along the gastrocolic ligament, during the initial operation thereby selecting the most advantageous site for the development of any subsequent fistula.