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.
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