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Revista Colombiana de Cirugía

versão impressa ISSN 2011-7582versão On-line ISSN 2619-6107

Resumo

TARAZONA-LEON, Cristian Eduardo et al. Pancreatic fistula: A feared complication. Experience in a fourth level hepatobiliopancreatic surgery unit. rev. colomb. cir. [online]. 2024, vol.39, n.2, pp.260-267.  Epub 17-Nov-2023. ISSN 2011-7582.  https://doi.org/10.30944/20117582.2415.

Introduction.

Postoperative pancreatic fistula is one of the most important complications in hepatobiliopancreatic surgery. Its diagnosis is made by the presence of an amylase level in the drainage fluid at least three times above the serum amylase value from the third postoperative day. The objective of this study was to characterize patients with postoperative pancreatic fistula at our institution, evaluating the importance of early detection and to establish a timely management.

Methods.

Descriptive, retrospective study that included patients who underwent pancreatoduodenectomy with a diagnosis of postoperative pancreatic fistula as a complication of hepatobiliopancreatic surgery at the Hospital Internacional Colombia, between January 2017 and December 2020. Patients with another type of procedure performed by this specialty and those who did not decide to participate in the study were excluded.

Results.

A total of 69 patients were included, the median age was 57 years with a predominance of females (n=38; 55.1%). 33.3% (n=24) of the operated patients developed postoperative pancreatic fistula, with 23.2% having a biochemical leak, grade B in 8.7% and grade C in 2.9%, for whom expectant management, ultrasound control and reintervention were indicated, respectively. Five patients died (7.2%).

Conclusions.

Pancreatic fistula is a complication to take into account in all patients undergoing pancreatoduodenectomy. There are strategies that can reduce the incidence of this complication and thus improve not only the outcome but also the prognosis and postoperative morbidity.

Palavras-chave : pancreas; pancreatic neoplasms; pancreatoduodenectomy; pancreatic fistula; postoperative complications.

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