Pancreatic fistula after pancreatectomy

Definitions, risk factors, preventive measures, and management - Review

Research output: Contribution to journalReview article

56 Citations (Scopus)

Abstract

Resection of pancreas, in particular pancreaticoduodenectomy, is a complex procedure, commonly performed in appropriately selected patients with benign and malignant disease of the pancreas and periampullary region. Despite significant improvements in the safety and efficacy of pancreatic surgery, pancreaticoenteric anastomosis continues to be the Achilles heel of pancreaticoduodenectomy, due to its association with a measurable risk of leakage or failure of healing, leading to pancreatic fistula. The morbidity rate after pancreaticoduodenectomy remains high in the range of 30% to 65%, although the mortality has significantly dropped to below 5%. Most of these complications are related to pancreatic fistula, with serious complications of intra-abdominal abscess, postoperative bleeding, and multiorgan failure. Several pharmacological and technical interventions have been suggested to decrease the pancreatic fistula rate, but the results have been controversial. This paper considers definition and classification of pancreatic fistula, risk factors, and preventive approach and offers management strategy when they do occur.

Original languageEnglish
Article number602478
JournalInternational Journal of Surgical Oncology
Volume2012
DOIs
Publication statusPublished - 2012

Fingerprint

Pancreatic Fistula
Pancreatectomy
Pancreaticoduodenectomy
Pancreas
Abdominal Abscess
Pharmacology
Hemorrhage
Morbidity
Safety
Mortality

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

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title = "Pancreatic fistula after pancreatectomy: Definitions, risk factors, preventive measures, and management - Review",
abstract = "Resection of pancreas, in particular pancreaticoduodenectomy, is a complex procedure, commonly performed in appropriately selected patients with benign and malignant disease of the pancreas and periampullary region. Despite significant improvements in the safety and efficacy of pancreatic surgery, pancreaticoenteric anastomosis continues to be the Achilles heel of pancreaticoduodenectomy, due to its association with a measurable risk of leakage or failure of healing, leading to pancreatic fistula. The morbidity rate after pancreaticoduodenectomy remains high in the range of 30{\%} to 65{\%}, although the mortality has significantly dropped to below 5{\%}. Most of these complications are related to pancreatic fistula, with serious complications of intra-abdominal abscess, postoperative bleeding, and multiorgan failure. Several pharmacological and technical interventions have been suggested to decrease the pancreatic fistula rate, but the results have been controversial. This paper considers definition and classification of pancreatic fistula, risk factors, and preventive approach and offers management strategy when they do occur.",
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