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. 2024 Nov;95(11):887-894.
doi: 10.1007/s00104-024-02176-w. Epub 2024 Sep 28.

[Anastomotic leakage in hepato-pancreato-biliary surgery]

[Article in German]
Emrullah Birgin  1 , Jan Heil  2 , Benjamin Walter  3 , Martin Wagner  3 , Benjamin Müssle  2 , Marko Kornmann  2 , Thomas Seufferlein  3 , Nuh N Rahbari  2
Affiliations

[Anastomotic leakage in hepato-pancreato-biliary surgery]

[Article in German]
Emrullah Birgin et al. Chirurgie (Heidelb). 2024 Nov.

Abstract
in English, German

Severe complications following hepato-pancreato-biliary surgery are frequently due to leakage of anastomoses. Local intraoperative and systematic measures can reduce the incidence of leaks and leak-related sequelae. The early identification of leak-related sequelae, such as hemorrhage is pivotal to reduce the mortality risk. Therefore, perioperative risk stratification incorporating surgical and patient risk factors is crucial. The management of anastomotic leaks is complex and an interdisciplinary treatment is therefore recommended. The treatment depends on the institutional expertise, localization, characteristic features of the anastomosis and the onset of insufficiency. This article describes the different concepts of the diagnostics, prevention, consequences and management of anastomotic leakage in hepato-pancreato-biliary surgery in more detail.

Schwerwiegende Komplikationen in der hepatopankreatobiliären Chirurgie sind häufig Folge von Anastomoseninsuffizienzen. Lokal-chirurgische und systemische Maßnahmen können dabei das Auftreten und die Folgen einer Insuffizienz abmildern. Insbesondere ist die Frühdetektion von Konsequenzen einer Insuffizienz wie die Arrosionsblutung wichtig, um das Mortalitätsrisiko zu reduzieren. Daher ist eine perioperative Risikostratifizierung unter Kenntnis eingriffstypischer und patienteneigener Risikofaktoren entscheidend. Das Management ist komplex und sollte stets interdisziplinär unter Berücksichtigung der institutionellen Expertise, der Lokalisation, Besonderheiten der Anastomose und Zeitpunkt der Insuffizienz erfolgen. Im vorliegenden Artikel werden verschiedene Konzepte zur Diagnostik, Prävention, Konsequenzen und Management der Anastomoseninsuffizienz in der hepatopankreatobiliären Chirurgie näher beleuchtet.

Keywords: Bile leak; Hepatectomy; Hepatobiliary surgery; Pancreatectomy; Pancreatic fistula.

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References

Literatur

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