title: Fluid collection after distal pancreatectomy: a frequent finding.
abstract: BACKGROUND
  Fluid collections (FC) at the resection margin of the pancreatic stump after distal pancreatectomy (DP) are common radiological findings in follow-up scans. No recommendations exist regarding the management of such findings. The aim was to characterise incidence, risk factors, clinical impact and therapy of FC.
  
  
  METHODS
  Data of 209 patients who underwent DP between 07/2009 and 06/2011 were prospectively collected and analysed, regarding follow-up CT or MRI scan findings of FC at the resection margin. FC was defined as a cyst-like lesion >1 cm in diameter.
  
  
  RESULTS
  A follow-up with at least two cross-sectional images was available in 159/209 patients. In the first postoperative control, 68 patients showed an FC (43%). FC size was classified as <5 cm (n = 38 pat.), 5-10 cm (n = 24 pat.) and >10 cm (n = 6 pat.). 20 patients (30%) showed clinical symptoms. Six patients (9%) required specific treatment, all other FC showed spontaneous regression. No correlation with stump closure techniques or preceding postoperative pancreatic fistula was found (4/68 patients, 6%). Multivariate analysis revealed standard resections as the only significant factor for FC.
  
  
  CONCLUSIONS
  FCs at the resection margin after DP are frequent and harmless findings. Therapeutic interventions are required in only 9% of all FC patients.
authors.affiliation: Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
authors.forename: Christin
authors.initials: C
authors.lastname: Tjaden
authors.affiliation: Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Hinz
authors.affiliation: Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hassenpflug
authors.affiliation: Department of Radiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Fritz
authors.affiliation: Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fritz
authors.affiliation: Diagnostik Munich, Diagnostic Imaging Center, Augustenstr. 115, 80798 Munich, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Grenacher
authors.affiliation: Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.affiliation: Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Electronic address: thilo.hackert@med.uni-heidelberg.de.
authors.forename: Thilo
authors.initials: T
authors.lastname: Hackert
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011237:Predictive Value of Tests; D012075:Remission, Spontaneous; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D049291:Seroma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome