Laparoscopic Roux-en-Y Fistulojejunostomy for Persistent External Pancreatic Fistulas

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Laparoscopic Roux-en-Y Fistulojejunostomy for Persistent External Pancreatic Fistulas

Florin Zaharie, Dan Valean, Roxana Zaharie, Roman Taulean, Emil Mois, Calin Popa, Alin Fetti, Andra Ciocan, Nadim Al Hajjar
Clinical case, no. 5, 2024
Article DOI: 10.21614/chirurgia.2938
Background: Persistent external pancreatic fistulas post-acute pancreatitis are a relatively rare complication, in an era of endoscopic and minimally invasive treatment, which can present a high rate of morbidity. Although most of the cases require surgical treatment, the possibility of a minimally invasive approach is yet to be established. This article highlights a case in which persistent external pancreatic fistula (PEPF) was managed laparoscopically, indicating the key steps, as well as the postoperative follow-up.

Case report: We present the case of a 55-year-old patient who developed acute gallstone pancreatitis, which was unsuccessfuly managed through endoscopic methods, and who underwent laparoscopic necrosectomy. Furthermore, the patient developed persistent external pancreatic fistula for which a laparoscopic Roux-en-Y fistulojejunostomy was performed with good postoperative recovery and follow-up.

Conclusion: Despite the scarcity of the procedure, laparoscopic Roux-En-Y Fistulojejunostomy can be considered an effective choice in the cases of persistent external pancreatic fistulas by taking the right precautions and with adequate case selection.

Keywords: fistulojejunostomy, laparoscopic, persistent external pancreatic fistula, minimally invasive