Torres O.J.M.a· Moraes-Junior J.M.A.a· Fernandes E.S.M.b· Hackert T.c

Author affiliations

aDepartment of Surgery, Hepatopancreatobiliary Unit, Presidente Dutra University Hospital – Maranhão Federal University, São Luiz, Brazil
bDepartment of Gastrointestinal and Transplant Surgery, Rio de Janeiro Federal University and São Lucas Hospital, Rio de Janeiro, Brazil
cDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany

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Article / Publication Details

First-Page Preview

Received: October 26, 2021
Accepted: December 19, 2021
Published online: March 02, 2022

Number of Print Pages: 9
Number of Figures: 6
Number of Tables: 3

ISSN: 2297-4725 (Print)
eISSN: 2297-475X (Online)

For additional information: https://www.karger.com/VIS

Abstract

____________________________________________________________________________________________ABSTRAC Background - The incidence of Grade C postoperative pancreatic fistula ranges from 2 to 11% depending on the type of pancreatic resection. This complication may frequently require early relaparotomy and the surgical approach remains technically challenging and is still associated with a high mortality. Infectious complications and post-operative hemorrhage are the two most common causes of reoperation. Summary - The best management of grade C pancreatic fistulas remains controversial and ranges from conservative approaches up to completion pancreatectomy. The choice of the technique depends on the patient’s conditions, intraoperative findings, and surgeon’s discretion. A pancreas-preserving strategy appears to be attractive, including from simple to more complex procedures such as debridement and drainage, and external wirsungostomy. Completion pancreatectomy should be reserved for selected cases, including stable patients with severe infection complication or hemorrhage after pancreatic fistula who do not respond to pancreas-preserving procedures. Key Messages - This review describes the current options for management of grade C pancreatic fistula after pancreatoduodenectomy with regard to indication, choice of procedure and outcomes of the different approaches.

© 2022 S. Karger AG, Basel

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First-Page Preview

Received: October 26, 2021
Accepted: December 19, 2021
Published online: March 02, 2022

Number of Print Pages: 9
Number of Figures: 6
Number of Tables: 3

ISSN: 2297-4725 (Print)
eISSN: 2297-475X (Online)

For additional information: https://www.karger.com/VIS

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