577
Views
17
CrossRef citations to date
0
Altmetric
Review

Pancreatic reconstruction techniques after pancreaticoduodenectomy: a review of the literature

ORCID Icon, , , , , , & show all
Pages 797-806 | Received 19 Apr 2019, Accepted 03 Jul 2019, Published online: 12 Jul 2019
 

ABSTRACT

Introduction: Postoperative pancreatic fistula is the most troublesome complication after pancreaticoduodenectomy, and is an on-going area of concern for pancreatic surgeons. The specific pancreatic reconstruction technique is an important factor influencing the development of postoperative pancreatic fistula after pancreaticoduodenectomy.

Areas covered: In this paper, we briefly introduced the definition and relevant influencing factors of postoperative pancreatic fistula. We performed a search of all meta-analyses published in the last 5 years and all published randomized controlled trials comparing different pancreatic anastomotic techniques, and we evaluated the advantages and disadvantages of different techniques.

Expert opinion: No individual anastomotic method can completely avoid postoperative pancreatic fistula. Selecting specific techniques tailored to the patient’s situation intraoperatively may be key to reducing the incidence of postoperative pancreatic fistula.

Article highlights

  • The risk factors for postoperative pancreatic fistula are multiple and complex, and include patient-related factors, pancreatic factors, surgical factors and perioperative management factors.

  • The incidence rate of postoperative pancreatic fistula after invagination pancreaticojejunostomy is similar to that after duct-to-mucosa pancreaticojejunostomy. The two methods have their own advantages and disadvantages.

  • Pancreaticogastrostomy is another safe pancreatic anastomotic method with an incidence of postoperative pancreatic fistula similar to that after pancreaticojejunostomy.

  • External pancreatic duct stents may reduce the rate and severity of postoperative pancreatic fistula in the setting of high-risk pancreatic anastomosis.

Acknowledgments

We thank Jane Charbonneau, DVM and Angela Morben, DVM, from Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Declaration of interest

The authors report no conflicts of interest.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by the grant of the Second Hospital of Jilin University.

Log in via your institution

Log in to Taylor & Francis Online

PDF download + Online access

  • 48 hours access to article PDF & online version
  • Article PDF can be downloaded
  • Article PDF can be printed
USD 99.00 Add to cart

Issue Purchase

  • 30 days online access to complete issue
  • Article PDFs can be downloaded
  • Article PDFs can be printed
USD 602.00 Add to cart

* Local tax will be added as applicable

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.