Management of biliary and pancreatic fistulae by fistulojejunostomy

Objective: to find out the outcome of fistulojejunostomy after traumatic biliary and pancreatic fistulae study design: descriptive setting: combined military hospital bahawalpur duration of study: 1993 -2006 patient and methods: during the period september 1993 to september 2006,a total number of 6 cases biliary and a case of pancreatic fistulae were treated at combined military hospital bahawalpur. all those patients who got surgical trauma to biliary surgery leading to biliary fistulae included in study. patients who developed pancreatic fistulae after the debridement of pancreatic necrosis following acute pancreatitis also included in the study. fistulous track dissected out deep to its origin,excised its excessive redundant part and then rou-en-y fistulojejunostomy (retro-colic) carried out in all these case. results: there had been leakage of bile from the nearby drainage tube,in two cases,which gradually stopped after 7 to 14 days. in five cases,there had been no leakage of bile from fistula-jejunostomy site. conclusion: fistula-jejunostomy is an excellent procedure for the management of biliary and pancreatic fistulae,where the surgeon is inexperienced in surgical repair of biliary and pancreatic ductal injuries and where the modern modalities like ercp,ptc and choledochoscopic interventions are not available.