A pancreatic fistula or anastomotic leak may develop after a pancreatectomy. These can be identified and graded based on criteria used at Memorial Sloan-Kettering Cancer Center.
Parameters:
(1) findings present
(2) presence of fistulous tract
(3) volume of amylase-rich fluid drained per day
Findings |
Fistulous Tract |
Volume of Drainage |
Diagnosis |
clinical |
present |
> 50 mL per day beyond day 10 |
pancreatic fistula |
clinical or radiologic |
absent |
> 50 mL per day beyond day 5 |
pancreatic anastomotic leak |
Outcome |
Grade |
resolves spontaneously (no intervention required) |
0 |
resolves with oral medication and/or bedside medical care |
1 |
resolves with IV medical therapy and/or total parenteral nutrition |
2 |
resolves with an invasive procedure (interventional radiology and/or endoscopic and/or operative procedure) |
3 |
does not resolve and results in chronic disability |
4 |
does not resolve and results in the death of the patient |
5 |
A fistula or anastomotic leak was considered significant if the Grade was >= 2.
Specialty: Gastroenterology, Surgery, general