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Charles J. Yeo, MD

Arch Surg. 2005;140:856.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Postoperative PF remains the Achilles’ heel of pancreaticoduodenectomy. Fortunately, many recent reports have indicated that most postoperative PFs can be managed conservatively, with good outcomes. This review from the University of California, Los Angeles, very nicely documents that postoperative PF was identified in 12.6% of patients and that postoperative PF was significantly more common when the underlying pathological diagnosis was an ampullary tumor or a benign cystic neoplasm. Patients with postoperative PF had more postoperative complications, including intra-abdominal abscess requiring drainage, wound infection, intra-abdominal bleeding, sepsis, biliary fistula, late biliary stricture, and need for reoperation. Fortunately, mortality rates and long-term survival were unaffected by the presence of a PF. Overall, 94.5% of patients had successful "conservative" management of their postoperative PF, basically relying on operatively placed drains. Numerous institutions have looked at their postoperative PF rates over the last several years. A large retrospective review done . . . [Full Text of this Article]

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