Introducing this monograph by expressing our heartfeIt thanks to all those who have contributed to its success may seem no more than a rhetorical exercise. However, at the same time we feel duty bound to add our sincere apologies, for we know that many of the dis tinguished authors of the various chapters have been hard put to find any relevant information in the existing literature. The plain fact is that very little has been said and written about pancreatic fistulas compared with other aspects of pancreatic disease. Why is this? Essentially, we believe there may be two main reasons: one practical explanation may be their relative rarity, while the other reas on is, as it were, "psychological", i. e. , pancreatic fistulas tend almost invariably to be regarded as complications of an imperfectly performed surgical procedure. However useful it might be if we were to do it more often, it goes against the grain to public1y admit one's own mistakes. Ever since I (P. P. ) started practising in medicine, it has been my destiny and privilege to work alongside Professor Dagradi, the pioneer ofpancreatic surgeryin Italy, and to assist him over the years in something like 2000 operations on the pancreatic gland. Clearly, then, any complication due or related to such surgery however rare, has become part and parcel of my practical day-to-day c1inical experience and scientific interests.

1 Functional Anatomy of the Pancreas: The Ductal System

2 Radiologic Imaging of Pancreatic Fistulas
3 Pathophysiology of Pancreatic Secretion in Relation to Presence of External Pancreatic Fistulas
4 Pancreatic Fistulas in Acute Pancreatitis
5 Pancreatic Fistulas in Chronic Pancreatitis
6 Pancreatic Fistulas and Tumors of the Pancreas
7 Pancreatic Fistulas in Pancreatic Transplantation
8 Pancreatic Fistulas After Exclusion of the Residual Stump in Resections of the Pancreatic Head
9 Internal Pancreatic Fistulas: Classification, Recognition, and Management
10 Microbiological Aspects of Pancreatic Fistulas
11 Antibiotics Secretion into Pancreatic Fluid
12 Artificial Nutrition in Pancreatic Fistulas
13 Drugs Inhibiting Exocrine Pancreatic Secretion
14 Limitations of Conservative Therapy of Pancreatic Fistulas
15 Pitfalls of Medical Treatment
16 The Use of Octreotide to Prevent Postoperative Complications After Major Pancreatic Resection
17 Surgical Treatment of Pancreatic Fistulas: Rationale, Timing, and Techniques
18 Treatment of Pancreatic Fistulas in Outpatients
19 Use of Fibrin Sealant in the Treatment of Pancreatic Fistulas
Pancreatic Fistulas: What Does the Future Hold in Store?.