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Minimizing Occurrence of Pancreatic Fistula during Pancreatoduodenectomy (Pd) Procedure: An Update

Abstract

Mohammad Abdul Mazid, Gazi Shahinur Akter , Zheng Hui Ye, Xiao-Ping Geng, Fu-Bao Liu, Yi-Jun Zhao, Fan-Huang, Kun Xie, Hong-Chuan Zhao

Background: Pancreatic fistula (PF) is the most widely recognized complication of pancreaticoduodenectomy (PD) with diversely reported occurrence rates. Present review focusses on dissecting the surgical treatment modalities that leads to development of PF.

Methods: A retrospective study with the use of hospital database as cases and controls was carried out. Data were tabulated and subjected to strong statistical analysis and inferences were drawn.

Results: As observed the occurrence of PF did not differ in terms of mean age, sex, surgical timings to the procedure, anastomosis techniques or vascular resection.

Conclusion: The surgical approach for PF is related with a higher mortality and morbidity. There is no preferred method of performing pancreatectomy as any procedure can give rise to same mortality rates and risk of endocrine deficiency. In instances of muddled PF, radiological or surgical conservative treatment is needed and surgically duct to mucosal double layered anastomosis have been successful in reducing the PF rates and its validation is still awaited from the trials.

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