Factors Influencing the Pancreatic Leakage after Pancreaticoduodenectomy

Kim, Hyun Sung; Jo, Hong Jae; Jeon, Tae Yong; Sim, Mun Sup

Abstract

BACKGROUND/AIMS: Pancreaticoduodenectomy is the procedure of choice in patients with periampullary cancers. Marked improvements in morbidity and mortality rates following pancreaticoduodenectomy have been reported in recent years. However, pancreatic leakage still occurs in 5% to 25% of patients and is a major cause of morbidity and mortality.
METHODS
Between January 1990 to June 1999, eighty-two patients underwent pancreaticoduodenectomy. We compared preoperative, intraoperative characteristics as well as postoperative sandostatin usage in those patients who experienced (n=21) versus those who did not experience pancreatic leakage (n=61). Information was retrospectively collected from hospital record.
RESULTS
The clinical leakage rate in this series was 25.6% (n=21). There were no significant differences in preoperative characteristics comparing those with versus those without pancreatic leakage. Among intraoperative characteristics, duct stenting and transfusions were significantly associated with the pancreatic leakage. Finally, postopeative sandostatin usage was able to reduce significantly the incidence of pancreatic leakage.
CONCLUSION
Although consensus among surgeons does not exist as to opeative tenchnique and postoperative management, stenting and less bleeding as well as sandostatin usage had better results in this study.