[Pancreatic fistula after left nephrectomy].

OBJECTIVES

To report our experience with pancreatic fistula after left nephrectomy to point out this unfrequent complication.

METHODS

We perform a chart review of 3 cases of pancreatic fistula after left nephrectomy experienced in our institution between 1983-2004.

RESULTS

All patients were males, with an average age of 51 years. Indications for nephrectomy were renal cell carcinoma, renal abscess and pyonephrosis. Classic Israel incision was the surgical approach in all three cases, with accidental opening of the peritoneum. Wound inflammatory signs appeared on third postoperative day, drainage of pancreatic juice on postoperative day 4. Treatment consisted on NPO 7 days, and intravenous hydration, atropin and wide spectrum antibiotics. Mean duration of pancreatic juice drainage was 8 days.

CONCLUSIONS

Pancreatic tail injury is a possible complication of left nephrectomy due to the close anatomical vicinity of both organs, that may be altered by tumoral or inflammatory disease of the kidney. If not recognized, it may lead to a pancreatic fistula, the diagnosis and treatment of which should be known by the urologist.