title: Natural history of intra-abdominal fluid collections following pancreatic surgery.
abstract: BACKGROUND
  Little data are available for non-abscess abdominal fluid collections (AFCs) after pancreatic surgery and their clinical implications. We sought to analyze the natural history of such collections in a population of patients subject to routine postoperative imaging.
  
  
  METHODS
  From 1995 to 2011, 709 patients underwent pancreatic resections and routine postoperative monitoring with abdominal ultrasound according to a unit protocol. AFCs were classified as asymptomatic (no interventional treatment), symptomatic (need for percutaneous drainage of sterile, amylase-poor fluid), and pancreatic fistula (drainage of amylase-rich fluid).
  
  
  RESULTS
  Ninety-seven of 149 AFCs (65 %) were asymptomatic and resolved spontaneously after a median follow-up of 22 days (interquartile range, 9-52 days). Among 52 (35 %) AFCs requiring percutaneous drainage, there were 20 pancreatic fistulas and 32 symptomatic collections. A stepwise logistic regression model identified three factors associated with the need for interventional treatment, i.e., body mass index ≥25 (odds ratio, 3.23; 95 % confidence interval (CI), 1.32 to 7.91), pancreatic fistula (odds ratio, 2.93; 95 % CI, 1.20 to 7.17), and biliary fistula (odds ratio, 3.92; 95 % CI, 1.35 to 11.31).
  
  
  CONCLUSIONS
  One fourth of patients develop various types of non-abscess AFCs after pancreatic surgery. Around half of them are asymptomatic and resolve spontaneously.
authors.affiliation: First Department of General and GI Surgery, Jagiellonian University Medical College, 40 Kopernika Street, 31-501, Krakow, Poland. marek.sierzega@uj.edu.pl
authors.forename: Marek
authors.initials: M
authors.lastname: Sierzega
authors.forename: Piotr
authors.initials: P
authors.lastname: Kulig
authors.forename: Piotr
authors.initials: P
authors.lastname: Kolodziejczyk
authors.forename: Jan
authors.initials: J
authors.lastname: Kulig
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D001658:Biliary Fistula / Q000209:etiology*; D015992:Body Mass Index; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011860:Radiography, Abdominal; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography; D055815:Young Adult