The pancreatic stump after pancreatoduodenectomy: the "Achille's heel" revisited...
Pancreatic fistula, the most dreaded complication of pancreatoduodenectomy occurs with an incidence ranging from 4-30% in literature reports; the incidence varies considerably according to the definition of fistula used. This literature review describes various methods proposed over the last decade to decrease the incidence and severity of pancreatic fistula including techniques of pancreatico-jejunal and pancreatico-gastric anastomoses, deliberate avoidance of pancreatico-enteric anastomosis, and the prophylactic role of somatostatin analogues.
Paye
F
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Service de chirurgie digestive, hôpital Saint-Antoine, UPMC Paris-06, 75012 Paris, France. francois.paye@sat.aphp.fr
D000672:Amputation Stumps / Q000601:surgery; D000714:Anastomosis, Surgical / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D019365:Metaphor; D010185:Pancreatic Fistula / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D012086:Reoperation; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D013004:Somatostatin