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VOLUME 2 , ISSUE 1 ( January-June, 2019 ) > List of Articles


Postoperative Pancreatic Fistula after a Left Cytoreductive Nephrectomy

Bharath N Kumar, Sanjeev Tandon, Irshad A Khan, Aditya A Jha

Keywords : Case report, Left cytoreductive nephrectomy, Metastatic renal cell carcinoma, Postoperative pancreatic fistula

Citation Information : Kumar BN, Tandon S, Khan IA, Jha AA. Postoperative Pancreatic Fistula after a Left Cytoreductive Nephrectomy. Journal of Medical Academics 2019; 2 (1):33-35.

DOI: 10.5005/jp-journals-10070-0026

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Aim: The aim of the study was to report a case of postoperative pancreatic fistula (POPF) in the setting of a left cytoreductive nephrectomy. Background: Pancreatic injury during nephrectomy is a rare complication with a reported incidence of 2.1% in laparoscopic left radical nephrectomy. It has not been described in the setting of cytoreductive nephrectomy (CN) and we report one such case. Case description: A 61-years-old male underwent left CN for metastatic left renal mass. On the 5th postoperative day, there was spontaneous expulsion of the retroperitoneal drain, two days after which the patient developed a serous discharge of 25–30 mL per day from the drain site, which later became purulent. The patient was managed successfully with pigtail drainage of the collection, culture-sensitive antibiotics, and subcutaneous injection of octreotide. Conclusion: Conservative management of POPF after nephrectomy in the form of drainage of retroperitoneal collection, antibiotics, somatostatin analogs, and discontinuing oral diet with total parenteral nutrition (TPN) (as indicated) is successful in most cases. Clinical significance: A pancreatic injury during a left CN is a distinct possibility, which can be managed successfully by conservative means.

  1. Varkarakis IM, Allaf ME, et al. Pancreatic injuries during laparoscopic urologic surgery. Urology 2004;64:1089–1093. DOI: 10.1016/j.urology.2004.06.032.
  2. Breda A, Finelli A, et al. Complications of laparoscopic surgery for renal masses: prevention, management, and comparison with the open experience. Eur Urol 2009;55(4):836–850. DOI: 10.1016/j.eururo.2009.01.018.
  3. Bassi C, Marchegiani G, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery 2017;161(3):584–591. DOI: 10.1016/j.surg.2016.11.014.
  4. Bassi C, Dervenis C, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005;138(1):8–13. DOI: 10.1016/j.surg.2005.05.001.
  5. Bozkurt M, Can O, et al. A Pancreatic Fistula as a Rare Complication of Laparascopic Radical Nephrectomy: A Case Report. Urol Case Rep 2017;12:20–22. DOI: 10.1016/j.eucr.2017.02.004.
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