A new nonoperative method of percutaneous transgastric fistulo-drainage for an intractable external pancreatic fistula--a case report.

The external pancreatic fistula is a well-known complication of pancreatectomy and is conventionally classified as either a partial fistula or a total fistula. A partial fistula usually closes spontaneously and operative intervention is rarely needed, whereas, a total fistula on the other hand, very often, does not close and may therefore require surgical intervention. We report herein, a case of an intractable total pancreatic fistula following pancreatoduodenectomy which was successfully repaired by a new nonoperative method of percutaneous transgastric fistulo-drainage (PTFD). This technique, performed under the control of a two-way X-ray television system, is safe and considered useful for the treatment of an intractable total pancreatic fistula. In the future, this may be the method of choice for the management of such refractory total pancreatic fistulae.