Pancreatic ifstula after central pancreatectomy:case series and review of the literature

摘要

BACKGROUND: Postoperative pancreatic ifstula is one of the most common complications after pancreatectomy. This study aimed to assess the occurrence and severity of pancreatic ifstula 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 ifve cases of central pancreatectomy. Pancreatic ifstula was deifned 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 ifstula 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 ifstula rate of the patients was 33.4% (0-100%). Of 279 patients, 250 (89.6%) had grade A or B ifstulae of ISGPF and were treated non-operatively, and the remaining 29 (10.4%) had grade C ifstulae of ISGPF. In 194 patients, 15 (7.7%) were re-operated upon. Only one patient with grade C ifstula of ISGPF died from multiple organ failure after re-operation. CONCLUSION: Despite the relatively high occurrence, most pancreatic ifstulae after central pancreatectomy are recognized a grade A or B ifstula of ISGPF, which can be treated conservatively or by mini-invasive approaches.