The Incidence Rate of Pancreatic Fistula Based on the Right and Left Drainage after the Whipple Surgery, and Affecting Factors

Considering the importance of on-time diagnosis of pancreatic fistula in patients undergoing pancreaticoduodenectomy (PD), the aim of this study was determining the efficiency of inserting two drains (right and left) in patients who underwent Whipple surgery to early diagnosis of pancreatic fistula by measuring the level of amylase in drains.

In this cross-sectional study in Alzahra hospital in Isfahan, Iran, during the years 2015-2016, all patients who underwent pancreaticoduodenectomy with inserting two drains according to surgeon's viewpoint were followed postoperatively for one year. They were evaluated for presentation of pancreatic fistula by measuring the level of amylase in drains.

According to International Study Group for Pancreatic Surgery (ISGPF) classification, out of 111 patients, 41 (36.9%) had pancreatic fistula. Based on the level of amylase in right and left drain, 61% and 58.5% had pancreatic fistula, respectively. In the right drain, the type of fistula was type A in 21 cases (84%) and type B in 4 cases (16%). In the left drain, the type of fistula was type A in 21 cases (87.5%) and type B in 3 cases (12.5%). The type of fistula was not significantly different in terms of the left and right drainage discharge (P = 0.640).

It seems that inserting two drains after Whipple surgery could predict pancreatic fistula; but there was not statistical difference between one or two drains.