Pancreatic fistula classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pancreatic fistula can be classified anatomically as internal fistula and external fistula.
Classification
Pancreatic fistula can be classified anatomically as;
- Internal fistula: The pancreatic duct communicates with internal organs or body cavity such as pleural or peritoneal cavity.
- External fistula: The pancreatic duct communicates with the skin, otherwise known as pancreaticocutaneous fistula.[1]
Pancreatic fistula can also be classified based on the anatomy of the pancreatic duct and the location of injury as;
- Type 1 pancreatic fistula: Involves injury to the pancreatic parenchyma with leakage from the distal part of the pancreatic duct or the side branches.
- Type 2 pancreatic fistula: Involves injury to and leak from the main pancreatic duct.
- Type 3 pancreatic fistula: Occurs as a result of proximal or distal pancreatectomy.[2]
Pancreatic fistula is classified into two categories on the basis of clinical manifestations, complications and severity by the ISGPF as;
- Biochemical pancreatic fistula: This category includes fistula with no significant clinical symptoms.
- Clinically relevant pancreatic fistula: This category includes fistulas under grade B and C, which shows significant clinical symptoms and require surgical interventions, re-surgeries and can complicate into organ failure and death.[3]
References
- ↑ Morgan KA, Adams DB (2007). "Management of internal and external pancreatic fistulas". Surg Clin North Am. 87 (6): 1503–13, x. doi:10.1016/j.suc.2007.08.008. PMID 18053844.
- ↑ Mutignani M, Dokas S, Tringali A, Forti E, Pugliese F, Cintolo M; et al. (2017). "Pancreatic Leaks and Fistulae: An Endoscopy-Oriented Classification". Dig Dis Sci. 62 (10): 2648–2657. doi:10.1007/s10620-017-4697-5. PMID 28780610.
- ↑ Jiang L, Ning D, Chen X (2020). "Prevention and treatment of pancreatic fistula after pancreatic body and tail resection: current status and future directions". Front Med. 14 (3): 251–261. doi:10.1007/s11684-019-0727-3. PMID 31840199.