Pancreatic fistula classification

Pancreatic fistula can be classified anatomically as internal fistula and external fistula. Pancreatic fistula can also be classified based on the anatomy of the pancreatic duct and the location of injury as Type 1 pancreatic fistula, Type 2 pancreatic fistula and Type 3 pancreatic fistula.

Pancreatic fistula can be classified anatomically as;

• Internal fistula: The pancreatic duct communicates with internal organs or body cavity such as pleural or peritoneal cavity.

• External fistula: The pancreatic duct communicates with the skin, otherwise known as pancreaticocutaneous fistula.^[1]

Pancreatic fistula can also be classified based on the anatomy of the pancreatic duct and the location of injury as;

• Type 1 pancreatic fistula: Involves injury to the pancreatic parenchyma with leakage from the distal part of the pancreatic duct or the side branches.
• Type 2 pancreatic fistula: Involves injury to and leak from the main pancreatic duct.
• Type 3 pancreatic fistula: Occurs as a result of proximal or distal pancreatectomy.^[2]

Pancreatic fistula is classified into two categories on the basis of clinical manifestations, complications and severity by the ISGPF as;

• Biochemical pancreatic fistula: This category includes fistula with no significant clinical symptoms.
• Clinically relevant pancreatic fistula: This category includes fistulas under grade B and C, which shows significant clinical symptoms and require surgical interventions, re-surgeries and can complicate into organ failure and death.^[3]

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