[Postoperative pancreatic fistulas: clinical study of a series of 114 consecutive cephalic duodeno-pancreatectomies].

Abstract

The present study explores the incidence, the predisposing factors and the consequences of pancreatic fistulae in a series of 114 consecutive, non selected, pancreatico-duodenal resections performed during the period January 1967-December 1982 for malignant and benign diseases of the (peri)ampullary region and the head of the pancreas. Overall hospital mortality reached 10.8% (12/114 pat.). The most common surgical complication was pancreatic fistula (17 pat.-14.9%) responsible for half of the postoperative fatal outcomes. The incidence of the pancreatic fistula is significantly influenced by a patient age of over 65 years, a preoperative serum bilirubin level exceeding 6 mg %, urgent degree of the intervention, presence of a renal insufficiency and last but not least by the poor quality of the pancreatic remnant. As surgical treatment of this complication is compromised by a high mortality (40% - 4/10 pat.), surgery should be reserved to hemorrhagic or persistent local or systemic, septic complications. Therefore more attention should be given to the prevention of this complication by a careful patient selection, based on evaluation of the different mentioned risk factors and by an adequate technique based on a separation of the different anastomoses by the greater omentum and the transverse mesocolon.

• Authors: J Lerut, P Gianello, M Reynaert, J B Otte, P J Kestens
• Journal: Acta chirurgica Belgica (Acta Chir Belg) 1985 May-Jun Vol. 85 Issue 3 Pg. 205-10 ISSN: 0001-5458 [Print] England
• Vernacular Title: Fistules pancréatiques post-opératoires: étude clinique sur une série de 114 duodéno-pancréatectomies céphaliques consécutives.
• PMID: 4036463 (Publication Type: English Abstract, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Biliary Tract Diseases (surgery)
• Duodenal Diseases (etiology, prevention & control, surgery)
• Female
• Humans
• Intestinal Fistula (etiology, prevention & control)
• Male
• Middle Aged
• Pancreatic Diseases (surgery)
• Pancreatic Fistula (etiology, prevention & control)
• Postoperative Complications (etiology)
• Retrospective Studies