Your browser doesn't support javascript.
loading
Postoperative pancreatic fistulas: preventing severe complications and reducing reoperation and mortality rate.
Pedrazzoli, Sergio; Liessi, Guido; Pasquali, Claudio; Ragazzi, Roberto; Berselli, Mattia; Sperti, Cosimo.
Afiliação
  • Pedrazzoli S; Clinica Chirurgica IV, University of Padova, General Hospital, Castelfranco Veneto (Treviso), Italy. sergio.pedrazzoli@unipd.it
Ann Surg ; 249(1): 97-104, 2009 Jan.
Article em En | MEDLINE | ID: mdl-19106683
BACKGROUND: Postoperative pancreatic fistula (POPF) is responsible for severe complications and death in patients who underwent pancreatic surgery. The reported success rate of conservative treatment is around 80%. Therefore up to 20% of patients usually need surgical treatment that can be repeated in some. Uncontrolled sepsis and massive hemorrhage are the main causes for mortality in this setting. METHOD: Four hundred forty-five patients underwent surgery for pancreatic diseases (January 1993-August 2007); 70 of them developed a POPF. An early aggressive treatment based on interventional radiology was applied to all patients. The drain's track and/or percutaneous approach was used to insert catheters into the peripancreatic fluid collection/s or abscess/es. The position of catheters was verified at least once a week. Surgery was performed in case of failure of conservative approach. RESULTS: Conservative treatment (approach by drain's track in 49, percutaneous in 16, mixed in 2) was successful in 67 patients. A patient under dialysis had the drains inserted during an emergency surgery for peritonitis 6 days after surgery; a second patient underwent repeated surgical debridement, and a third patient underwent a procedure on the abdominal wall to separate a POPF from a colonic fistula. No patient with diagnosed POPF died. CONCLUSIONS: Early aggressive interventional radiology allowed managing conservatively 95.7% of POPF preventing severe complications and avoiding death.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Fístula Pancreática Tipo de estudo: Observational_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Ano de publicação: 2009 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Fístula Pancreática Tipo de estudo: Observational_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Surg Ano de publicação: 2009 Tipo de documento: Article País de afiliação: Itália