Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Mar 15:11:105-118.
doi: 10.2147/CEG.S120217. eCollection 2018.

Postoperative pancreatic fistula: a review of traditional and emerging concepts

Affiliations
Review

Postoperative pancreatic fistula: a review of traditional and emerging concepts

Christopher B Nahm et al. Clin Exp Gastroenterol. .

Abstract

Postoperative pancreatic fistula (POPF) remains the major cause of morbidity after pancreatic resection, affecting up to 41% of cases. With the recent development of a consensus definition of POPF, there has been a large number of reports examining various risk factors, prediction models, and mitigation strategies for this costly complication. Despite these strategies, the rates of POPF have not significantly diminished. Here, we review the literature and evidence regarding both traditional and emerging concepts in POPF prediction, prevention, and management. In particular, we review the evidence for the association between postoperative pancreatitis and POPF, and present a novel proposed mechanism for the development of POPF.

Keywords: distal pancreatectomy; pancreaticoduodenectomy; postoperative pancreatic fistula; postoperative pancreatitis.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Hypothesized mechanism for the development of postoperative pancreatitis and POPF. Abbreviations: IOAC, intraoperative amylase concentration; UT-2, urinary trypsinogen-2; POPF, postoperative pancreatic fistula.

References

    1. Iacono C, Verlato G, Ruzzenente A, et al. Systematic review of central pancreatectomy and meta-analysis of central versus distal pancreatectomy. Br J Surg. 2013;100(7):873–885. - PubMed
    1. Berger AC, Howard TJ, Kennedy EP, et al. Does type of pancreaticojejunostomy after pancreaticoduodenectomy decrease rate of pancreatic fistula? A randomized, prospective, dual-institution trial. J Am Coll Surg. 2009;208(5):738–747. discussion 747–749. - PubMed
    1. Pedrazzoli S. Pancreatoduodenectomy (PD) and postoperative pancreatic fistula (POPF): a systematic review and analysis of the POPF-related mortality rate in 60,739 patients retrieved from the English literature published between 1990 and 2015. Medicine (Baltimore) 2017;96(19):e6858. - PMC - PubMed
    1. Aston SJ, Longmire WP., Jr Management of the pancreas after pancreaticoduodenectomy. Ann Surg. 1974;179(3):322–327. - PMC - PubMed
    1. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138(1):8–13. - PubMed