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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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
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author Salvia, Roberto
Lionetto, Gabriella
Perri, Giampaolo
Malleo, Giuseppe
Marchegiani, Giovanni
author_facet Salvia, Roberto
Lionetto, Gabriella
Perri, Giampaolo
Malleo, Giuseppe
Marchegiani, Giovanni
author_sort Salvia, Roberto
collection PubMed
description 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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spelling pubmed-83976762021-09-15 Total pancreatectomy and pancreatic fistula: friend or foe? Salvia, Roberto Lionetto, Gabriella Perri, Giampaolo Malleo, Giuseppe Marchegiani, Giovanni Updates Surg Review Article 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. Springer International Publishing 2021-08-07 2021 /pmc/articles/PMC8397676/ /pubmed/34363601 http://dx.doi.org/10.1007/s13304-021-01130-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review Article
Salvia, Roberto
Lionetto, Gabriella
Perri, Giampaolo
Malleo, Giuseppe
Marchegiani, Giovanni
Total pancreatectomy and pancreatic fistula: friend or foe?
title Total pancreatectomy and pancreatic fistula: friend or foe?
title_full Total pancreatectomy and pancreatic fistula: friend or foe?
title_fullStr Total pancreatectomy and pancreatic fistula: friend or foe?
title_full_unstemmed Total pancreatectomy and pancreatic fistula: friend or foe?
title_short Total pancreatectomy and pancreatic fistula: friend or foe?
title_sort total pancreatectomy and pancreatic fistula: friend or foe?
topic Review Article
url 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
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