Predictors of external pancreatic fistulas development after surgical treatment of infected pancreatonecrosis

Abstract

Aim. To determine the risk factors for the development of external pancreatic fistulas in the outcome of infected pancreatonecrosis, which do not close as a result of conservative treatment.
 Materials and methods. The results of treatment were analyzed in 44 patients with pancreatonecrosis. The influence of different risk factors for the development of external pancreatic fistulas after surgery for infected pancreatonecrosis was studied, using Spearman’s correlation coefficient.
 Results. The repeated surgeries one year after pancreatonecrosis were required by 9 % of patients in connection with pancreatic cysts and for 11.36 % – with external pancreatic fistulas. There was observed a positive correlation of a mean value between the formation of external pancreatic fistulas, which did not close after intensive conservative therapy and the localization of necrosis zone in the region of isthmus (r = 0.31, p = 0.00), its depth 50 % and more (r = 0.46, p = 0.00), quantity of outflow (r = 0.55, p = 0.00) with amylase activity > 1000 units (r = 0.53, p = 0.00).
 Conclusions. Localization of necrosis zone in the region of isthmus, necrosis depth 50 % and more, quantity of control drainage outflow > 150 ml, high amylase activity in drainage > 1000 units are predictors of the formation of external pancreatic fistulas in the outcome of acute destructive pancreatitis, which need surgical correction.