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  Vol. 124 No. 5, May 1989 TABLE OF CONTENTS
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Management of pancreatic fistulas

F. M. Martin, R. L. Rossi, J. L. Munson, S. G. ReMine and J. W. Braasch
Department of General Surgery, Lahey Clinic Medical Center, Burlington, Mass 01805.

Conservative management of pancreatic fistulas resulting from trauma, operation for tumor, or operation for pancreatitis has met with variable success. To assess optimal management strategies and outcome, we reviewed the records of 35 patients with external pancreatic fistulas (26 patients), pancreatic ascites (6 patients), or pancreatic pleural effusion (3 patients). Treatment included no operation in 5 patients, oversewing of the fistula in 7 patients, internal drainage in 11 patients, and resection in 12 patients. One (3%) postoperative death occurred. The overall rate of operative success was 83% (25 patients). The incidence of recurrent fistulas was about the same regardless of the procedure. Patients treated successfully without operation did not have pancreatitis as an underlying disease. Patient selection is of great importance in the decision to resect or to drain and is based in part on imaging the pancreatic duct and fistula.

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Risk Analysis of Pancreatic Fistula After Pancreatic Head Resection
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Arch Surg 1998;133:1094-1098.
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