Embedding fistulojejunostomy: An easy and secure technique for refractory external pancreatic fistula

Luo, Shao-Ciao; Cheng, Shao-Bin; Wu, Chien-Hung; Huang, Chun-Te; Lin, Yi-Ling; P’eng, Fang-Ku

doi:10.1016/j.asjsur.2016.09.005

Cited by 8 publications

(9 citation statements)

References 7 publications

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“…Over subsequent years, variants of fistulojejunostomy have been described with similar outcomes and no demonstrable superiority of one technique over other (5,6,10).…”

Section: Discussionmentioning

confidence: 99%

“…Embedding fistulojejunostomy has been suggested by Luo et al, in which the fistula tract is disconnected from the abdominal wall and drained externally through a transluminal tube drain, with both the drain and the tract fixed to a Roux loop of the jejunum with seromuscular sutures (5). The drain is also fixed to the abdominal wall with absorbable sutures and removed after 30 days.…”

Section: Discussionmentioning

confidence: 99%

“…The emergent surgical options include lavage with wide drainage, reinforcing or refashioning of anastomosis in case of a minor leak, disconnection of anastomosis with external pancreatic drainage in feding jejunostomy, and rarely a total pancreatectomy, which leads to debilitating brittle diabetes and carries a prohibitively high mortality (5)(6)(7). Persistent external pancreatic fistula (PEPF) is defined as an external pancreatic fistula not resolving with these measures for longer than 6 weeks (1).…”

Section: Introductionmentioning

confidence: 99%

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Roux-en-Y fistulojejunostomy in the management of persistent external pancreatic fistula: is it olde worlde?

et al. 2019

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Objective: This article aimed to identify patient selection criteria and approach in treating persistent external pancreatic fistulas surgically with Rouxen-Y fistulojejunostomy, and the study evaluated the outcomes of Roux-en-Y fistulojejunostomy with a review of the relevant literature. Material and Methods: A retrospective data analysis from January 2010 to May 2017 revealed 6 patients managed with Roux-en-Y fistulojejunostomy for persistent external pancreatic fistulas, and their details were entered in a proforma. Standard surgical steps were performed in all patients, and the patients were followed up postoperatively for 1 year. Data were analyzed for outcomes, and the literature was reviewed. Results: Four of 6 patients had persistent external pancreatic fistulas following pancreatic necrosectomy, 1 had surgery for pancreatic pseudocyst, and 1 after pancreaticoduodenectomy for pancreatic head mass. An average duration of conservative management was 14 weeks, and Roux-en-Y fistulojejunostomy was performed at a median distance of 6 cm from pancreas via a midline laparotomy. All patients recovered without major complications. Only 1 patient developed diabetes at a 1-year follow-up. Conclusion: Fistulojejunostomy is a safe and effective treatment for persistent pancreatic fistula having the benefit of avoiding a difficult major pancreatic resectional surgery in an already debilitated patient with frozen tissue planes, along with low postoperative morbidity and mortality. The short-and mid-term outcomes in the literature for this procedure are good, as it has also been seen in our study on diverse indications.

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“…Over subsequent years, variants of fistulojejunostomy have been described with similar outcomes and no demonstrable superiority of one technique over other (5,6,10).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Roux-en-Y fistulojejunostomy in the management of persistent external pancreatic fistula: is it olde worlde?

et al. 2019

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“…The optimal time of performing fistulojejunostomy is still a matter of debate. Across various studies, timing ranges from 2 months to 1 year (1,5,6,9,10). Bassi et al have recommended 6 to 12 weeks after identification of PEPF as the appropriate time (3).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Roux-en-Y fistulojejunostomy in the management of persistent external pancreatic fistula: Is it olde worlde?

Desai¹,

Narkhede²,

Pande³

et al. 2018

Turk J Surg

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Fistulojejunostomy is a safe and effective treatment for persistent pancreatic fistula having the benefit of avoiding a difficult major pancreatic resectional surgery in an already debilitated patient with frozen tissue planes, along with low postoperative morbidity and mortality. The short- and mid-term outcomes in the literature for this procedure are good, as it has also been seen in our study on diverse indications.

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Fistulo-jejunostomy as an Alternative Treatment in the Repair of a Complex Biliary Leak

Molina

Maestro

Delgado

et al. 2020

Cirugía Española (English Edition)

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Embedding fistulojejunostomy: An easy and secure technique for refractory external pancreatic fistula

Abstract: EFJ makes fistulojejunostomy easier and more secure with a satisfactory early and long-term outcome. It may be a desirable technique for REPF.

Cited by 8 publications

References 7 publications

Roux-en-Y fistulojejunostomy in the management of persistent external pancreatic fistula: is it olde worlde?

Roux-en-Y fistulojejunostomy in the management of persistent external pancreatic fistula: is it olde worlde?

Roux-en-Y fistulojejunostomy in the management of persistent external pancreatic fistula: Is it olde worlde?

Fistulo-jejunostomy as an Alternative Treatment in the Repair of a Complex Biliary Leak

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