title: Pancreatic fistula after central pancreatectomy: case series and review of the literature.
abstract: BACKGROUND
  Postoperative pancreatic fistula is one of the most common complications after pancreatectomy. This study aimed to assess the occurrence and severity of pancreatic fistula after central pancreatectomy.
  
  
  METHODS
  The medical records of 13 patients who had undergone central pancreatectomy were retrospectively studied, together with a literature review of studies including at least five cases of central pancreatectomy. Pancreatic fistula was defined and graded according to the recommendations of the International Study Group on Pancreatic Fistula (ISGPF).
  
  
  RESULTS
  No death was observed in the 13 patients. Pancreatic fistula developed in 7 patients and was successfully treated non-operatively. None of these patients required re-operation. A total of 40 studies involving 867 patients who underwent central pancreatectomy were reviewed. The overall pancreatic fistula rate of the patients was 33.4% (0-100%). Of 279 patients, 250 (89.6%) had grade A or B fistulae of ISGPF and were treated non-operatively, and the remaining 29 (10.4%) had grade C fistulae of ISGPF. In 194 patients, 15 (7.7%) were re-operated upon. Only one patient with grade C fistula of ISGPF died from multiple organ failure after re-operation.
  
  
  CONCLUSIONS
  Despite the relatively high occurrence, most pancreatic fistulae after central pancreatectomy are recognized a grade A or B fistula of ISGPF, which can be treated conservatively or by mini-invasive approaches.
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University; Oncologic Center of Xiamen, Xiamen 361003, China. Binl1962@sina.cn.
authors.forename: Yan-Ming
authors.initials: YM
authors.lastname: Zhou
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Zhang
authors.forename: Lu-Peng
authors.initials: LP
authors.lastname: Wu
authors.forename: Xu
authors.initials: X
authors.lastname: Su
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Le-Hua
authors.initials: LH
authors.lastname: Shi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000401:mortality; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome