Characterization of patients with postoperative pancreatic fistula after pancreaticoduodenectomy

Authors

Keywords:

pancreaticoduodenectomy, pancreatic fistula, pancreaticojejunostomy.

Abstract

Introduction: The cephalic pancreaticoduodenectomy is one of the most complex procedures in general surgery. The postoperative pancreatic fistula is the main cause of cephalic pancreaticoduodenectomy´s morbidity and the most dangerous one.
Objective: To characterized the patients with postoperative pancreatic fistula after pancreaticoduodenectomy.
Methods: An observational, descriptive, longitudinal and retrospective study was made in the Hepatobiliopancreatic Surgery Service of the Medical-Surgical Research Center, between 2008 and 2020. 54 patients were selected for been treated with cephalic pancreaticoduodenectomy from those, 12 patients with postoperative pancreatic fistula were taken as sample. Descriptive Statistics techniques were used to calculate absolute frequency, percentage, media, extreme values and standard deviation.
Results: The postoperative pancreatic fistula occurred in 12 cases for a 22,2 % of all patients. The mean age of was 61 years old, and the ratio female: male was 1:2. The Types A and B were the most frequently fistula with 5 cases each one and the clinically relevant postoperative pancreatic fistula was and 58,4 % of all cases.
Conclusions: The postoperative pancreatic fistula is presented in patients older than 60-years-old and mostly man. Only a few presented severe clinical manifestations due to the fistula. It is not occurred in patient treated for benign diseases.

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Author Biographies

Karel Borroto Martínez, Centro de Investigaciones Médico-Quirúrgicas

Especialista de Primer Grado en Cirugia General. Profesor Asistente. Investigador Agregado. Diplomado en Gestion de la Informacion en Salud. Diplomado en Cirugia Oncologica.

Sheyla Moret Vara, Centro de Investigaciones Médico-Quirúrgicas

Doctora en Ciencias Médicas. Especialista en I Grado en Medicina General Integral. Especialista en I Grado en Cirugía General. Profesora Auxiliar. Investigadora Agregada. Máster en Urgencias Médicas.

Yoanna Ramírez Fernández, Centro de Investigaciones Médico-Quirúrgicas

Especialista de Primer Grado en Cirugía General. Especialista de Primer Grado en Medicina General Integral. Profesora Instructora. Diplomante en Ginecología Oncológica.

Ismael Rodríguez Rodríguez, Centro de Investigaciones Médico-Quirúrgicas

Especialista de Primer Grado en Cirugía General. Profesor Asistente. Diplomado en Broncoscopia.

References

1. Yang Y, Fu X, Zhu S, Cai Z, Qiu Y, Mao L. Vater's ampullary carcinoma increases the risk of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy : A retrospective and propensity score-matched analysis. BMC Gastroenterology. 2022; 22:51-58. DOI: 10.1186/s12876-022-02128-w

2. Yao GL, An MJ, Fan YG. Invaginated duct to mucosa pancreaticojejunostomy reduce postoperative pancreatic leakage: a matched case-controlled study. Medicine. 2021; 100:49(e27834). DOI: 10.1097/MD.0000000000027834

3. Kou HW, Hsu CP, Chen YF, Huang JF, Chang SC, Lee CW et al. The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study. Healthcare. 2022; 10:126. DOI: 10.3390/healthcare10010126

4. Vasilescu AM, Andriesi-Rusu DF, Bradea C, Vlad N, Lupascu-Ursulescu C, Cianga-Spiridon IA et al. Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology. Life. 2021; 11:1216. DOI: 10.3390/life11111216

5. Shen J, Guo F, Sun Y, Zhao J, Hu J, Ke Z et al. Predictive nomogram for postoperative pancreatic fistula following pancreaticoduodenectomy: a retrospective study. BMC Cancer. 2021; 21:550. DOI: 10.1186/s12885-021-08201-z

6. Dhayat SA, Tamim ANJ, Jacob M, Ebeling G, Kerschke L, Kabar I et al. Postoperative pancreatic fistula affects recurrence-free survival of pancreatic cancer patients. PLoS ONE. 2021; 16(6):e0252727. DOI: 10.1371/journal.pone.0252727

7. Jena SS, Meher D, Ranjan R. Delayed pancreatic fistula: An unaccustomed complication following pancreaticoduodenectomy- a rare case report. Annals of Medicine and Surgery. 2021; 66:102460. DOI: 10.1016/j.amsu.2021.102460

8. Paik KY, Oh JS, Kim EK. Amylase level after pancreaticoduodenectomy in predicting postoperative pancreatic fistula. Asian Journal of Surgery. 2021; 44:636e640. DOI: 10.1016/j.asjsur.2020.11.022

9. Grego A, Friziero A, Serafini S, Belluzzi A, Moletta L, Saadeh LM, et al. Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis. Cancers. 2021; 13:5803. DOI: 10.3390/cancers13225803

10. Purkayastha J, Bannoth S, Talukdar A, Borthakur BB, Kalita D, Das G. Postoperative pancreatic fistulas after pancreaticoduodenectomy for malignancy: A Northeast Indian tertiary cancer center study. JGH Open: An open access journal of gastroenterology and hepatology. 2021; 5:1009-1014. DOI: 10.1002/jgh3.12609

11. Adamu M, Plodeck V, Adam C, Roehnert A, Welsch T, Weitz J et al. Predicting postoperative pancreatic fistula in pancreatic head resections: which score fits all? Langenbeck's Archives of Surgery. 2022; 407:175-188. DOI: 10.1007/s00423-021-02290-x

12. Ricci C, Ingaldi C, Alberici L, Pagano N, Mosconi C, Marasco G et al. Blumgart Anastomosis After Pancreaticoduodenectomy. A Comprehensive Systematic Review, Meta-Analysis, and Meta-Regression. World J Surg. 2021; 45:1929-1939. DOI: 10.1007/s00268-021-06039-x

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Published

2023-06-20

How to Cite

1.
Borroto Martínez K, Moret Vara S, Ramírez Fernández Y, Rodríguez Rodríguez I. Characterization of patients with postoperative pancreatic fistula after pancreaticoduodenectomy. Rev Cubana Med Milit [Internet]. 2023 Jun. 20 [cited 2025 Apr. 1];52(3):e02302667. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2667

Issue

Vol. 52 No. 3 (2023): July - september

Section

Brief Communication

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