N Alexakis1, R Sutton, J P Neoptolemos. 1. Department of Surgery, University of Liverpool, UCD Building, Royal Liverpool University Hospital, Daulby Street, Liverpool L69 3GA, UK.
Abstract
BACKGROUND: Pancreatic fistula remains a significant problem in pancreatic disease, trauma and surgery. Whilst improved diagnostic and treatment techniques, including endoscopic approaches, have resulted in considerably improved outcomes, surgical intervention remains an important aspect of treatment but has been relatively poorly documented. AIMS: The aims were to review the recent world literature on the relative incidence of pancreatic fistula and the results of surgical treatment. RESULTS: The pancreatic fistula rate following partial pancreato-duodenectomy was 421 (12.9%) in 3,268 patients in 13 large series; 80 (13.0%) in 671 patients after left pancreatectomy in 6 large series, and 28 (11.9%) in 243 patients after pancreatic trauma in 4 recent series. The success rate of surgical procedures for external pancreatic fistulae was 101 (90.2%) in 112 patients with an overall mortality of 7 (6.3%) reported in 9 series. For internal pancreatic fistulae the success rate of surgical treatment was 61 (92%) in 66 patients with an overall mortality of 6 (9%) reported in 7 series. CONCLUSIONS: The treatment of established pancreatic fistula remains challenging. Although surgical treatment is reserved for patients who have failed all other treatments, the success rate is 90-92% but with a mortality of 6-9%. Copyright 2004 S. Karger AG, Basel.
BACKGROUND:Pancreatic fistula remains a significant problem in pancreatic disease, trauma and surgery. Whilst improved diagnostic and treatment techniques, including endoscopic approaches, have resulted in considerably improved outcomes, surgical intervention remains an important aspect of treatment but has been relatively poorly documented. AIMS: The aims were to review the recent world literature on the relative incidence of pancreatic fistula and the results of surgical treatment. RESULTS: The pancreatic fistula rate following partial pancreato-duodenectomy was 421 (12.9%) in 3,268 patients in 13 large series; 80 (13.0%) in 671 patients after left pancreatectomy in 6 large series, and 28 (11.9%) in 243 patients after pancreatic trauma in 4 recent series. The success rate of surgical procedures for external pancreatic fistulae was 101 (90.2%) in 112 patients with an overall mortality of 7 (6.3%) reported in 9 series. For internal pancreatic fistulae the success rate of surgical treatment was 61 (92%) in 66 patients with an overall mortality of 6 (9%) reported in 7 series. CONCLUSIONS: The treatment of established pancreatic fistula remains challenging. Although surgical treatment is reserved for patients who have failed all other treatments, the success rate is 90-92% but with a mortality of 6-9%. Copyright 2004 S. Karger AG, Basel.
Authors: Riccardo Casadei; Claudio Ricci; Giovanni Taffurelli; Anna Guariniello; Anthony Di Gioia; Mariacristina Di Marco; Nico Pagano; Carla Serra; Lucia Calculli; Donatella Santini; Francesco Minni Journal: J Gastrointest Surg Date: 2016-07-14 Impact factor: 3.452
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