Postoperative pancreatic fistula: a review of traditional and emerging concepts

Christopher B Nahm, Saxon J Connor, Jaswinder S Samra, Anubhav Mittal, Christopher B Nahm, Saxon J Connor, Jaswinder S Samra, Anubhav Mittal

Abstract

Postoperative pancreatic fistula (POPF) remains the major cause of morbidity after pancreatic resection, affecting up to 41% of cases. With the recent development of a consensus definition of POPF, there has been a large number of reports examining various risk factors, prediction models, and mitigation strategies for this costly complication. Despite these strategies, the rates of POPF have not significantly diminished. Here, we review the literature and evidence regarding both traditional and emerging concepts in POPF prediction, prevention, and management. In particular, we review the evidence for the association between postoperative pancreatitis and POPF, and present a novel proposed mechanism for the development of POPF.

Keywords: distal pancreatectomy; pancreaticoduodenectomy; postoperative pancreatic fistula; postoperative pancreatitis.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Hypothesized mechanism for the development of postoperative pancreatitis and POPF. Abbreviations: IOAC, intraoperative amylase concentration; UT-2, urinary trypsinogen-2; POPF, postoperative pancreatic fistula.

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Source: PubMed

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