Detailed measures to reduce the incidence and severity of pancreatic fistula after pancreaticoduodenectomy

Abstract

The pancreatic fistula is a common postoperative complication and the main cause of death of pancreaticoduodenectomy (PD). The incidence and development of postoperative pancreatic fistula have its inherent laws. To reduce the incidence and severity of pancreatic fistula, therefore, it is necessary to analyze the occurrence and development mechanism. The main factors for the occurrence of pancreatic fistula after Whipple or Child PD include insufficiency of anastomotic suture of the pancreaticojejunal anastomosis and high pressure in the jejunum loop around the anastomosis. The main factors for the development of pancreatic fistula include mixed pancreatic fistula and poor drainage around the anastomosis. Detailed measures to prevent the occurrence and development of pancreatic fistula mainly include improving the quality of anastomotic suture of pancreaticojejunal anastomosis, effectively reducing the pressure inside the jejunum loop, reducing the mixed leakage liquid corrosivity through the optimized digestive tract reconstruction to separate the biliary and pancreatic drainage and ensuring effective drainage around the anastomotic site. Key words: Pancreaticoduodenectomy; Pancreatic fistula; Incidence; Severity; Prevention