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Treatment of Postoperative Pancreatic Fistula Following Pancreatic Resection

Filip Cecka, Bohumil Jon, Vladimír Blaha P Zdenek Subrt and Alexander Ferko

Objective: Pancreatic resection is the only potentially curative modality in patients with carcinoma of the pancreas and periampullary region. Morbidity associated with pancreatic resections remains high with the most common cause of complications being pancreatic fistula (PF). PF occurs not only after pancreatic resections, it can develop after pancreatic trauma and acute or chronic pancreatitis as well. As the PF occurring after pancreatic resection may have different course than in other causes, the management is also different. The aim of this study was to evaluate our own results of pancreatic resections with focus on the treatment of PF. Methods: Hospital records from patients who underwent pancreatic resection from January 2010 through December 2012 were identified from our prospectively entered pancreatic surgery database. The postoperative management was standardized for all patients. Outputs from all drains were recorded daily. The amylase concentration was measured on postoperative day 3. If the amylase concentration was above three times the normal serum value, the drain was kept in place and the measurement was repeated every other day. Postoperative complications and their treatment were recorded into our database.