Utilizing pre-operative 3D printed model to inform pancreaticogastric fistula treatment: A case report.

INTRODUCTION

Pancreaticogastric fistula is a very rare phenomenon typically caused by mucinous neoplasms of the pancreas. We present a case report of a patient who developed a pancreaticogastric fistula as a sequela of chronic pancreatitis, which has never been reported in the literature.

PRESENTATION OF CASE: The patient had a benign inflammatory pancreatic head mass causing pancreatic duct and common bile duct obstruction eventually leading pancreaticogastric fistula formation located just anterior to the splenic artery. A three-dimensional (3D)-printed model of the patient's complex anatomy was created for presurgical planning utilizing both computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP). The patient underwent Puestow pancreaticojejunostomy, choledochojejunostomy, and takedown of pancreaticogastric fistula to successfully decompressed the pancreatic duct and common bile duct.

DISCUSSION: The use of 3D printing allowed for improved presurgical planning and patient education relating to a rare and complex surgical problem. The patient underwent a successful surgery which led to resolution of his symptoms.

CONCLUSION

3D printing is a useful tool for both surgeons and patients to understand complex surgical anatomy.