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Jeffrey B. Matthews, MD

Arch Surg. 2006;141:1076.

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

Although fistula after pancreatic resection has become less life threatening, it remains a challenge to prevent and treat. This complication is at least as common after DP as after Whipple resection. This 13-year audit by Pannegeon et al of 175 patients who underwent DP, despite its suboptimal retrospective, uncontrolled study design, is sufficiently large to address possible risk factors. Pannegeon et al confirm published findings that direct pancreatic duct suture and transection at the pancreatic neck are associated with lower rates of fistula. As with Whipple resection, somatostatin analog administration after DP did not decrease the rate of fistula and was of limited value in its treatment. An underemphasized observation in this study (but one that is well known to experienced surgeons) is that fistula after DP tends to present late, typically days after resumption of an oral diet. This has important implications for American practice, . . . [Full Text of this Article]

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Pancreatic Fistula After Distal Pancreatectomy: Predictive Risk Factors and Value of Conservative Treatment
Virginie Pannegeon, Patrick Pessaux, Alain Sauvanet, Marie-Pierre Vullierme, Reza Kianmanesh, and Jacques Belghiti
Arch Surg. 2006;141(11):1071-1076.
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