What is a postoperative pancreatic fistula?

Postoperative pancreatic fistula (POPF) is one of the most severe complications after pancreatic surgeries. POPF develops as a consequence of pancreatic juice leakage from a surgically exfoliated surface and/or anastomotic stump, which sometimes cause intraperitoneal abscesses and subsequent lethal hemorrhage.

How long pancreatic fistula takes to heal?

Results. Seventy-five patients (12.9%) developed a pancreatic fistula. Fistulas were managed with gradual withdrawal of surgical drains. This allowed for patient discharge and eventual closure at a mean of 18 days in 38.7% of cases; these were classified as low-impact fistulas.

How do you fix a pancreatic fistula?

Endoscopic therapy is usually the preferred method for many pancreatic fistulas. With an ERCP, sphincterotomy and/or placement of a pancreatic stent is performed to promote the flow of pancreatic secretions into a chosen internal drainage route.

What is a frequent complication of Whipple surgery?

The most common complication is post-op leaking of pancreatic juices from the site of the incision. A drain may need to be inserted through the skin to allow for the juices to drain, perhaps for several weeks. A rare but severe complication after surgery is bleeding from the gastroduodenal artery).

What causes a pancreatic fistula?

Internal pancreatic fistulas are most commonly caused by disruption of the pancreatic duct due to chronic pancreatitis. The chronic pancreatitis is usually alcoholic in origin in adults, and traumatic in origin in children. They may also be caused by leakage from a pancreatic pseudocyst.

How long does pancreatic drain stay in?

The stomach needs to be well drained until it is functioning. The gastrostomy tube is the most comfortable and safest way to achieve this. Most patients return home with the gastrostomy tube taped to their sides. After two weeks, the surgeon can safely remove the tube in the office with minor if any discomfort.

When should pancreatic drain be removed?

Conclusions: In patients at low risk of pancreatic fistula, intra-abdominal drains can be safely removed on POD 3 after standard pancreatic resections. A prolonged period of drain insertion is associated with a higher rate of postoperative complications with increased hospital stay and costs.

What causes pancreatic fistulas?

How is pancreatic fistula diagnosed?

A pancreatic fistula is typically diagnosed by measuring the amylase content of fluid from the peripancreatic drain; a drain amylase content greater than three times the serum amylase on or after POD 3 is pathognomonic for a fistula.

What is a frequent complication of pancreaticoduodenectomy also known as Whipple surgery?

The most common post-surgical complication of pancreatoduodenectomy is leaking of pancreatic juices from the incision. If this occurs, a drain may be inserted through the skin to allow drainage for several weeks after surgery. Weight loss is another frequent complication of the Whipple procedure.

What is the life expectancy after Whipple surgery?

For some pancreatic patients, however, a complex surgery known as the Whipple procedure may extend life and could be a potential cure. Those who undergo a successful Whipple procedure may have a five-year survival rate of up to 25%.