To summarize the diagnosis and treatment of pancreatic head carcinoma patients with anastomotic leakage and infection after pylorus-preserving pancreaticoduodenectomy (PPPD).

From February 2014 to August 2016, twelve patients had anastomotic leak complicated with infection of pancreatic head carcinoma after PPPD operation in Sichuan Xuanhan People’s Hospital. They received conservative treatment, including fasting, intravenous nutrition, water and electrolyte balance management, drainage and decompression, and original sinus placement of double lumen drainage tube. Meanwhile, drug treatment by injection of reduced glutathione+trimethoprim were given.

Conservative treatment failed in 2 patients, who were transferred to open operation. All patients were cured, with no sepsis, abdominal infection or skin infection. Gastric emptying disorder was found in 2 cases. The fistua healing time was (39.4±5.4) d; after 72 h treatment, serum amylase (AMY), urinary trypsin activation peptide (TAP) and C-reactive protein (CRP) levels were lower than those before treatment, the differences were statistically significant (t=24.651, 18.092, 4.135, all P<0.01).

For patients with pancreatic head carcinoma undergoing anastomotic leakage complicated with infection after PPPD operation, it needs to strengthen the management of drainage, infection control, continuous gastrointestinal decompression, parenteral and enteral nutrition support, and drug application. The pancreatic fistula or severe intestinal fistula should be found and given definite diagnosis as soon as possible, followed by comprehensive treatment and necessary surgery measurement.