V.V. Kalentjev1, D.A. Chichevatov2, A.E. Glukhov2
1Penza Regional Oncology Hospital, Penza
2Penza State University, Penza
Chichevatov D. A. – MD, Professor, Department of Surgery
40 Krasnaya St., 440026 Penza, Russian Federation, tel.: +7-927-366-35-85, e-mail: chichevatov69@mail.ru, ORCID ID: 0000-0001-6436-3386
Abstract. Pancreaticoduodenectomy (PDE) remains a common surgical procedure for periampular tumors. A postoperative pancreatic fistula (POPF) is the most harmful complication which may be associated with mortality of up to 40%. The objective of this systematic review was to assess the current incidence of POPF, its risk factors, and surgical methods for preventing the complication. A 10-year meta-analysis of 47 groups comprising 22,721 patients demonstrated a high rate of POPF – 0.13 [0.11–0.15]. The main risk factors for POPF have traditionally been the soft texture of the pancreatic parenchyma and a non-dilated pancreatic duct. The discussion exhibits that to date there are no universal highly reliable pancreatic anastomoses capable of preventing the formation of POPF.
Key words: pancreaticoduodenectomy, postoperative pancreatic fistula, insufficiency of pancreatic anastomosis.