Postoperative pancreatic fi stula (POPF) is the most common major complication after pancreatoduodenectomy (PD) and it can lead to prolonged hospital stay, increased costs, and mortality. The POPF rate is strictly correlated to the defi nition applied, but there are so many different defi nitions in the literature that comparison between published series of patients is diffi cult. The International Study Group of Pancreatic Fistula (IGSPF) has developed a new defi nition, with a grading system able to stratify complicated patients into three groups, based upon the clinical implications and costs of their postoperative course. The most important risk factors identifi ed are a soft pancreatic texture and a main pancreatic duct diameter of 3 mm or less. Several surgical techniques have been studied in order to prevent anastomotic leakage, but none has been demonstrated to be superior to others. The use of somatostatin analogues is still matter of controversy. Conservative management of POPF is usually effective, but in patients with deteriorating clinical status with evidence of sepsis, surgical management is needed.

Pancreatic fistula: definition and current problems.

BUTTURINI, Giovanni;DASKALAKI, Despoina;MOLINARI, Enrico;SCOPELLITI, Filippo;CASAROTTO, Andrea;BASSI, Claudio
2008-01-01

Abstract

Postoperative pancreatic fi stula (POPF) is the most common major complication after pancreatoduodenectomy (PD) and it can lead to prolonged hospital stay, increased costs, and mortality. The POPF rate is strictly correlated to the defi nition applied, but there are so many different defi nitions in the literature that comparison between published series of patients is diffi cult. The International Study Group of Pancreatic Fistula (IGSPF) has developed a new defi nition, with a grading system able to stratify complicated patients into three groups, based upon the clinical implications and costs of their postoperative course. The most important risk factors identifi ed are a soft pancreatic texture and a main pancreatic duct diameter of 3 mm or less. Several surgical techniques have been studied in order to prevent anastomotic leakage, but none has been demonstrated to be superior to others. The use of somatostatin analogues is still matter of controversy. Conservative management of POPF is usually effective, but in patients with deteriorating clinical status with evidence of sepsis, surgical management is needed.
2008
pancreatic fistula (PF); pancreatoduodenectomy; pancreatic fistula definition
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/339635
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