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David L. Berger, MD

Arch Surg. 2008;143(10):971.

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

Postoperative pancreatic fistula remains the most troublesome complication after PD. Several methods can be used for pancreatic reconstruction after resection. Each method has its proponents and its advantages and disadvantages. Nevertheless, POPFs continue to occur.

Bachellier and colleagues are advocates of telescoped PG as their method for primary reconstruction and believe that this reduces the incidence of POPF. They report a small case series using PG for patients they thought required reexploration for severe POPF and compare these patients with another small older cohort of patients who underwent completion pancreatectomy for POPF before the authors' conversion to using PG for reconstruction.

First and foremost, reoperative surgery for POPF is extremely rare and should almost never be undertaken. Perioperative drainage controls most POPFs, and patients who subsequently develop signs of sepsis undergo computed tomography and subsequent percutaneous drainage. Although POPFs occur, the reoperative rate for POPF should . . . [Full Text of this Article]

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