| Current management of pancreatic fistula after pancreaticoduodenectomy. | |
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MedLine Citation:
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PMID: 17011903 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pancreatic fistula (PF) is a major and serious complication following pancreaticoduodenectomy (PD). The purpose of this study was to outline our management of PF after PD. METHODS: A retrospective review of a prospectively collected database of 396 patients undergoing PD for various indications at Loyola University Medical Center and Hines Veterans Administration Hospital from July 1, 1990, to December 31, 2005. Patients were divided group 1 (no PF) and group 2 (PF). Each group was compared regarding preoperative, intraoperative, and postoperative outcomes. RESULTS: Of the patients included in the study, 65 patients (16%) developed a PF. PF was more common after PD for ampullary neoplasms (28%), duodenal neoplasms (35%), and serous cystic neoplasms (44%), and was uncommon after PD for pancreatic cancer (6%). Associated complications with PF was 51% when compared with patients with no PF (21%; P </= .001). Duration of hospital stay was 16 days in PF versus 9 days in no PF (</=.001). Intraoperative blood loss was greater in the PF versus no PF group (P = .01). Clinically serious postoperative complications in the PF versus no PF group were mortality (P = .03), intraabdominal abscess (P </= .001), wound infection (P </= .001), hemorrhage (P = .01), cardiac (P </= .001), bile leak (P </= .001), and reoperation (P = .02). Of the 62 surviving patients with PF, 36 (58%) were treated with maintenance of oral diet, 25 (40%) with parenteral nutrition, and 1 (1.6%) required surgery for closure of PF. CONCLUSIONS: PF is a serious complication after PD and is associated with substantial mortality and other complications. The majority of patients with PF can be managed conservatively with either maintenance of oral diet or parenteral nutrition until closure of the PF. |
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Authors:
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Gerard V Aranha; Joshua M Aaron; Margo Shoup; Jack Pickleman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgery Volume: 140 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-10-02 Completed Date: 2006-11-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: United States |
Other Details:
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Languages: eng Pagination: 561-8; discussion 568-9 Citation Subset: AIM; IM |
Affiliation:
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Division of Surgical Oncology, the Department of Surgery, Loyola University, Maywood, Illinois, USA. garanha@lumc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Databases, Factual Diet Drainage Female Gastrointestinal Neoplasms / surgery* Humans Male Pancreatic Fistula / diet therapy*, etiology, radiography Pancreaticoduodenectomy* Parenteral Nutrition Postoperative Complications / diet therapy* Reoperation Retrospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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