Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2019; 7(17): 2526-2535
Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2526
Impact of continuous local lavage on pancreatic juice-related postoperative complications: Three case reports
Tomohide Hori, Kohei Ogawa, Hidekazu Yamamoto, Hideki Harada, Kazuyoshi Matsumura, Michihiro Yamamoto, Masahiro Yamada, Takefumi Yazawa, Katsutoshi Kuriyama, Masaki Tani, Daiki Yasukawa, Yasuyuki Kamada, Yuki Aisu, Ryotaro Tani, Ryuhei Aoyama, Shinnosuke Nakayama, Yudai Sasaki, Koki Nishimoto, Masazumi Zaima
Tomohide Hori, Hidekazu Yamamoto, Hideki Harada, Michihiro Yamamoto, Masahiro Yamada, Takefumi Yazawa, Masaki Tani, Yasuyuki Kamada, Ryotaro Tani, Ryuhei Aoyama, Yudai Sasaki, Masazumi Zaima, Department of Surgery, Shiga General Hospital, Moriyama 524-8524, Japan
Kohei Ogawa, Department of Hepatobiliary Pancreatic and Breast Surgery, Ehime University, Toon 791-0295, Japan
Kazuyoshi Matsumura, Katsutoshi Kuriyama, Shinnosuke Nakayama, Koki Nishimoto, Department of Gastroenterology and Hepatology, Shiga General Hospital, Moriyama 524-8524, Japan
Daiki Yasukawa, Department of Surgery, Shiga University of Medical Science, Otsu 520-2192, Japan
Yuki Aisu, Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
Author contributions: Hori T performed the surgeries, wrote the report, and created all original illustrations and schemas; all authors assisted with surgical and endoscopic therapies, assessing important papers, and providing academic opinions; Zaima M supervised this research.
Informed consent statement: Consent was obtained from the patient for the publication of this report.
Conflict-of-interest statement: No authors have potential conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Tomohide Hori, FACS, MD, PhD, Associate Professor, Attending Doctor, Doctor, Surgeon, Department of Surgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama 524-8524, Japan.
Telephone: +81-77-5825031 Fax: +81-77-5825426
Received: February 24, 2019
Peer-review started: February 26, 2019
First decision: June 19, 2019
Revised: July 10, 2019
Accepted: July 20, 2019
Article in press: July 20, 2019
Published online: September 6, 2019
Core Tip

Core tip: Pancreatic fistula after pancreatic surgery is a potentially fatal refractory complication. We describe the typical findings based on three patients who survived, and two patients who died of fatal complications. We also discuss the importance of intensive treatment for postoperative pancreatic fistula, with a literature review. Continuous local lavage (CLL) has been reevaluated as an effective treatment for severe infected pancreatitis, and our findings show that CLL shortened the therapeutic duration for postoperative pancreatic fistula. We suggest that CLL has therapeutic potential for postoperative pancreatic fistula. We also introduce our institutional protocol for CLL for postoperative pancreatic fistula.