Nutritional support in the management of external pancreatic fistulas.

A prospective analysis of 20 patients with external pancreatic fistulas was undertaken over a 5-year period to evaluate the response of pancreatic fistulas to non-operative management. In 90% of patients fistula followed external trauma to the pancreas. There were 18 males and 2 females and the average age was 30.3 years. Fifteen patients were given enteral nutrition alone and 5 received total parenteral nutrition; 2 of these received somatostatin as well. All the fistulas healed spontaneously within 7-80 days, with no deaths. We conclude that if the patient's condition is stable external pancreatic fistulas can be managed safely and effectively by non-operative means. Nutritional support, especially via the enteral route if possible, is beneficial.