Aim of this study: Was to identify the risk factors and the outcome of management of pancreatic fistula 
after pancreatic resection. 
Methods: This prospective study included 65 consecutive pancreaticoduodenectomy performed for 
patients with pancreatic or periampullary tumors. Pancreatico-jejunal anastomosis was done by duct-tomucosa method in 57 patients and by dunking method in 8 patients. Postoperative evaluation included 
estimation of the drain output and its amylase content. 
Results: The patients were 34 (52.3%) males and 31 (47.7%) females. Nine patients (13.8%) developed 
fistula. There was statistically significant association between the development of pancreatic fistula and 
small caliber of pancreatic duct <3mm, soft pancreas, plasma albumin < 3gm/dl and dunking anastomosis. 
Five patients recovered by conservative treatment alone. Three patients needed interventional radiology in 
addition to conservative treatment. Two patients died. 
Conclusion: Many risk factors of pancreatic fistula were identified. The majority of pancreatic fistulae 
could be treated successfully by conservative treatment alone or with interventional radiology.