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Review
. 2008 Oct 14;14(38):5789-96.
doi: 10.3748/wjg.14.5789.

Pancreatic fistula after pancreatectomy: evolving definitions, preventive strategies and modern management

Shailesh-V Shrikhande  1 , Melroy-A D'Souza
Affiliations
Review

Pancreatic fistula after pancreatectomy: evolving definitions, preventive strategies and modern management

Shailesh-V Shrikhande et al. World J Gastroenterol. .

Abstract

Pancreatic resection is the treatment of choice for pancreatic malignancy and certain benign pancreatic disorders. However, pancreatic resection is technically a demanding procedure and whereas mortality after a pancreaticoduodenectomy is currently < 3%-5% in experienced high-volume centers, post-operative morbidity is considerable, about 30%-50%. At present, the single most significant cause of morbidity and mortality after pancreatectomy is the development of pancreatic leakage and fistula (PF). The occurrence of a PF increases the length of hospital stay and the cost of treatment, requires additional investigations and procedures, and can result in life-threatening complications. There is no universally accepted definition of PF that would allow standardized reporting and proper comparison of outcomes between different centers. However, early recognition of a PF and prompt institution of appropriate treatment is critical to the prevention of potentially devastating consequences. The present article, reviews the evolution of post resection pancreatic fistula as a concept, and discusses evolving definitions, the current preventive strategies and the management of this problem.

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Figures

Figure 1
Figure 1
Approach to management of post pancreatectomy PF. Other procedures to manage complex PF may have to be added.
See this image and copyright information in PMC

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