Pancreatic anastomotic failure after pancreaticoduodenectomy.
BACKGROUND
Pancreatic anastomotic failure has historically been regarded as one of the most feared complications after pancreaticoduodenectomy.


METHODS
We reviewed our recent experience (59 cases), March 1994 to December 1998, with pancreaticoduodenectomy and compared preoperative and intraoperative characteristics as well as outcomes in those patients who experienced (n = 10) versus those who did not experience a postoperative pancreatic leak (n = 49). Information was retrospectively collected from hospital records, office records, and interviews with patients.


RESULTS
The clinical leak rate in this series was 8.5%. There were no significant differences in preoperative or intraoperative characteristics comparing those with versus those without a postoperative pancreatic leak. Only 1 of 10 patients with a postoperative pancreatic leak required reoperation to manage the leak. Those with a pancreatic leak had more other postoperative complications (median 2 versus 0 complications per patient, P = 0.01) and longer hospital duration compared with those without a leak (median 13 versus 23 days, P<0.01). Overall mortality in the series was 3.4%; no mortalities occurred as a result of a pancreatic leak.


CONCLUSIONS
In the 1990s pancreatic anastomotic leak remains a potentially lethal problem after pancreaticoduodenectomy. Pancreatic leakage after pancreaticoduodenectomy is associated with other postoperative complications and a longer hospital stay.
Grobmyer
S R
SR
Department of Surgery, New York Presbyterian Hospital-Joan and Sanford I. Weill Medical College of Cornell University, New York, New York 10021, USA.
Rivadeneira
D E
DE
Goodman
C A
CA
Mackrell
P
P
Lieberman
M D
MD
Daly
J M
JM
D000368:Aged; D000714:Anastomosis, Surgical; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010189:Pancreatic Juice; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure