Laparoscopic "Roux-en-Y" Fistulojejunostomy for Persistent External Pancreatic Fistulas

Background: Persistent external pancreatic fistulas post-acute pancreatitis are a relatively rare complication, in an era of endoscopic and minimally invasive treatment, which can present a high rate of morbidity. Although most of the cases require surgical treatment, the possibility of a minimally invasive approach is yet to be established. This article highlights a case in which persistent external pancreatic fistula (PEPF) was managed laparoscopically, indicating the key steps, as well as the postoperative follow-up. Case report: We present the case of a 55-year-old patient who developed acute gallstone pancreatitis, which was unsuccessfuly managed through endoscopic methods, and who underwent laparoscopic necrosectomy. Furthermore, the patient developed persistent external pancreatic fistula for which a laparoscopic Roux-en-Y fistulojejunostomy was performed with good postoperative recovery and follow-up. Conclusion: Despite the scarcity of the procedure, laparoscopic Roux-En-Y Fistulojejunostomy can be considered an effective choice in the cases of persistent external pancreatic fistulas by taking the right precautions and with adequate case selection.