Hama Naoki, Kashiwazaki Masaki, Asukai Kei, Hata Tomoki, Mizumoto Sachiko, Nakanishi Misuzu, Hamano Rie, Maekawa Takayo, Yoshioka Shinichi, Taniguchi Masaaki, Tsujie Masaki, Konishi Muneharu, Yano Hiroshi
Dept. of Surgery, Hyogo Prefectural Nishinomiya Hospital.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2027-9.
The case was an 80-year-old woman with inferior bile duct cancer. The patient had undergone subtotal stomach-preserving pancreaticoduodenectomy with end-to-side pancreaticojejunostomy. Postoperative pancreatic fistula was observed in a short period and was treated by somatostatin analog administration and abscess drainage. Despite these conservative therapies, pancreatic fistula resulted in abdominal bleeding from the branch of dorsal pancreatic artery, which stopped by emergent transcatheter arterial embolization. Because pancreatic fistula had become refractory, the intestinal decompression catheter insertion was performed under local anesthesia to the jejunum located directly below abdominal wall. After this surgery, pancreatic fistula was resolved over a few weeks. This technique could be safely performed and avoided the injury of drainage fistula, and was considered to be an option for treating refractory pancreatic fistula.
