Total pancreatectomy and pancreatic fistula: friend or foe?

Postoperative pancreatic fistula (POPF) still represents the major driver of surgical morbidity after pancreaticoduodenectomy. The purpose of this narrative review was to critically analyze current evidence supporting the use of total pancreatectomy (TP) to prevent the development of POPF in patient...

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Detalles Bibliográficos
Autores principales: Salvia, Roberto, Lionetto, Gabriella, Perri, Giampaolo, Malleo, Giuseppe, Marchegiani, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Review Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397676/
https://www.ncbi.nlm.nih.gov/pubmed/34363601
http://dx.doi.org/10.1007/s13304-021-01130-3
Descripción
Sumario:Postoperative pancreatic fistula (POPF) still represents the major driver of surgical morbidity after pancreaticoduodenectomy. The purpose of this narrative review was to critically analyze current evidence supporting the use of total pancreatectomy (TP) to prevent the development of POPF in patients with high-risk pancreas, and to explore the role of completion total pancreatectomy (CP) in the management of severe POPF. Considering the encouraging perioperative outcomes, TP may represent a promising tool to avoid the morbidity related to an extremely high-risk pancreatic anastomosis in selected patients. Surgical management of severe POPF is only required in few critical scenarios. In this context, even if anecdotal, CP might play a role as last resort in expert hands. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13304-021-01130-3.

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