[Postoperative pancreatic fistulas: clinical study of a series of 114 consecutive cephalic duodeno-pancreatectomies].
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.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000601:surgery; D004378:Duodenal Diseases / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies
Fistules pancréatiques post-opératoires: étude clinique sur une série de 114 duodéno-pancréatectomies céphaliques consécutives.