Recurrent pancreatic fistula occurring after nephrectomy in patients with a renal hydatid cyst

Abstract

Pancreatic fistula (PF) is an important complication that may develop during intra-abdominal surgeries and following distal pancreas trauma. In the early period, drainage from the surgical site and increased amylase production based on the biochemical examination of the drainage fluid are the factors for diagnosis. In contrast, in association with fluid collected from the surgical site, intra-abdominal abscess and high fever may lead to the diagnosis in the late period. Endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of intra-abdominal fluid collection after PF and intra-abdominal percutaneous stent placement as well as the placement of a pancreatic stent in the pancreatic channel may be alternative methods to stop drainage. However, the complete resolution of fluid drainage may take months. In our case, drainage from the pancreatic fistula area took longer to resolve than the periods previously reported in the English literature. The tail of the pancreas can be injured during the extraction of especially aggressive and metastatic masses from organs near to the distal pancreas. Injury to the tail of the pancreas can also occur during the extraction of benign-like renal hydatid cysts and/or malignant left kidney masses. However, PF can be treated with noninvasive methods, such as percutaneous treatment and ERCP.