Pancreaticogastrostomy for pancreatic ascites.

Background/Aims: Management of pancreatic ascites is challenging. The aim of the present study was to study the role of pancreaticogastrostomy in management of pancreatic ascites. Methodology: Retrospective analysis of twelve operated cases with pancreatic ascites following failed conservative and endoscopic treatment was done for its outcome in terms of morbidity and a successful outcome. Patient data, imaging information and surgical procedure were noted. Results: Four of the 12 patients with leak from the dilated main pancreatic duct had longitudinal pancreaticogastrostomy. The gross edematous jejunum and a shortened mesentery due to sub-acute peritonitis necessitated this surgery. None had recurrence of ascites. Steatorrhea was distinctly absent. None had deterioration of endocrine function. Conclusions: Longitudinal pancreaticogastrostomy is a viable option in patients with pancreatic ascites and dilated main pancreatic duct especially in those with a shortened mesentery and an edematous small bowel.