Pancreatic Anastomotic Leakage after Pancreaticoduodenectomy. Risk factors, Clinical predictors, and Management (Single Center Experience)

Background Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) remains a challenge even at high-volume centers. Methods This study was designed to analyze perioperative risk factors for POPF after PD and evaluate the factors that predict the extent and severity of leak. Demogr...

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Bibliographic Details
Published in:World journal of surgery 2013-06, Vol.37 (6), p.1405-1418
Main Authors: El Nakeeb, Ayman, Salah, Tarek, Sultan, Ahmad, El Hemaly, Mohamed, Askr, Waleed, Ezzat, Helmy, Hamdy, Emad, Atef, Ehab, El Hanafy, Ehab, El-Geidie, Ahmed, Abdel Wahab, Mohamed, Abdallah, Talaat
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adolescent
Adult
Aged
Aged, 80 and over
Amylase
Anastomotic Leak - epidemiology
Anastomotic Leak - surgery
Body Mass Index
Cardiac Surgery
Child
Drainage Fluid
Female
Gastroduodenal Artery
General Surgery
Hospital Mortality
Humans
Liver Cirrhosis - complications
Male
Medicine
Medicine & Public Health
Middle Aged
Pancreatic Duct
Pancreatic Ducts - pathology
Pancreatic Fistula
Pancreaticoduodenectomy
Predictive Value of Tests
Retrospective Studies
Risk Factors
Surgery
Thoracic Surgery
Vascular Surgery
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Summary:Background Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) remains a challenge even at high-volume centers. Methods This study was designed to analyze perioperative risk factors for POPF after PD and evaluate the factors that predict the extent and severity of leak. Demographic data, preoperative, intraoperative, and postoperative variables were collected. Results A total of 471 consecutive patients underwent PD in our center. Fifty-seven patients (12.1 %) developed a POPF of any type; 21 patients (4.5 %) had a fistula type A, 22 patients (4.7 %) had a fistula type B, and the remaining 14 patients (3 %) had a POPF type C. Cirrhotic liver ( P  = 0.05), BMI > 25 kg/m 2 ( P  = 0.0001), soft pancreas ( P  = 0.04), pancreatic duct diameter 
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-013-1998-5