Current Status of Prevention of Pancreatic Fistula after Pancreaticoduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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Department of Surgery, The Second Affiliated Hospital, Zhejiang University of Medical College, Hangzhou 310031;

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PancreaticoduodenectomyPancreatic fistulaPrevention

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ObjectiveTo evaluate the various methods in prevention of pancreatic fistula after pancreaticoduodenectomy.MethodsThe literatures over the years related to prevention of pancreatic fistula were reviewed.ResultsManagement of the pancreatic stump following pancreaticoduodenectomy played the most important role in preventing pancreatic fistula. None of the methods of pancreatic stump had proved to be perfect in preventing pancreatic fistula, though pancreaticojejunostomy was the most widely practiced reconstruct strategy in varieties of option. For pancreaticojejunostomy and pancreaticogastrostomy, the rate of this complication was 12.3% and 11.1%,respectively. In recent years, a new procedure, bindingup pancreaticoduodenectomy, had shown a promise and excellent results in prevention of pancreatic fistula, the rate of fistula was 0 for consecutive 100 cases after pancreaticoduodenectomy.ConclusionBindingup pancreaticojejunostomy have a definite effect to avoid pancreatic fistula and be worthy of being recommended

Citation： LIU Yingbin,BAI Mingdong,PENG Shuyong,et al.. Current Status of Prevention of Pancreatic Fistula after Pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(3): 215-217. doi: Copy

1.	Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes [Ｊ]. Ann Surg, 1997; 226(3)∶248.
2.	Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 222(5)∶580.
3.	Staley CA, Lee JE, Cleary KR, et al. Preoperative chemoradiation, pancreaticoduodenectomy, and intraoperative radiation therapy for adenocarcinoma of pancreatic head [Ｊ]. Am J Surg, 1996; 171(1)∶118.
4.	Matsumoto Y, Fujii H, Miura K, et al. Successful pancreatojejunal anastomosis for pancreaticoduodenectomy [Ｊ]. Surg Gynecol Obstet, 1992; 175(5)∶555.
5.	Marcus ST, Cohen H, Ranson JHC, et al. Optimal management of the pancreatic remnant after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 221(6)∶635.
6.	Tsuji M, Kimura H, Konixhi K, et al. Management of continuous anastomosis of pancreatic duct and jejunal mucous after pancreaticoduodenectomy: historical study of 300 patients [Ｊ]. Surgery, 1998; 123(6)∶617.
7.	Bottger TC, Juniner T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: critical analysis of 221 resections [Ｊ]. World J Surg, 1999; 23(2)∶164.
8.	Bottger TC, Juniner T. Treatment of tumors of the pancreatic head with suspected but unproved malignancy: is a nihilistic approach justified [Ｊ]. World J Surg, 1999; 23(2)∶158.
9.	Berberat PO, Friess H, Kleeff J, et al. Prevention and treatment of complications in pancreatic cancer surgery [Ｊ]. Dig Surg, 1999; 16(4)∶327.
10.	Baumel H, Huguier JC, Manderscheid JM. Results of resection of cancer of exocrine pancreas: a study from the French association of surgery [Ｊ]. Br J Surg, 1994; 81(1)∶102.
11.	Sauvanet A, Belghiti J. Prevention of pancreatic fistula after cephalic duodenopancreatectomy [Ｊ]. Ann Chir, 1999; 53(7)∶612.
12.	Bartoli FG, Amonet GB, Ravera G, et al. Pancreatic fistula and relative mortality in malignant disease after pancreaticoduodenectomy. Review and statistical meta analysis regarding 15 years of literature [Ｊ]. Anticancer Res, 1991; 65(11)∶1831.
13.	張志偉，蔡中瑞，何柏威，等. 胰十二指腸切除術后并發胰瘺的預防 [Ｊ]. 中華外科雜志，1997； 35（3）∶192.
14.	杜春淵，汪俊堂. 空腸漿肌袖與胰腺端端吻合防止胰十二指腸切除術后胰瘺技術 [Ｊ]. 當代醫師雜志， 1996； 1（5）∶50.
15.	岳茂興，李學彪，張圭顯. 胰空腸套入荷包縫合完全胰液外引流術預防胰十二指腸切除術后胰瘺 [Ｊ]. 中華外科雜志， 1997； 35（6）∶ 370.
16.	彭淑牖，吳育連，彭承宏，等. 捆綁式胰腸吻合術（附28例報告） [Ｊ]. 中華外科雜志， 1997； 35（3）∶158.
17.	彭淑牖，牟一平，江獻川，等. 胰斷端空腸漿肌鞘內套入吻合術（附11例報告） [Ｊ]. 中國實用外科雜志，1996； 16（10）∶12.
18.	彭淑牖，吳育連，彭承宏，等. 一種確保不發生胰瘺的術式——捆綁式胰腸吻合術 [Ｊ]. 普外基礎與臨床雜志，1997； 4（4）∶ 242.
19.	Grace PA, Pitt HA, Tompkins RK, et al. Decreased mobility and mortality after pancreaticoduodenectomy [Ｊ]. Am J Surg, 1986; 151(2)∶141.
20.	Ohwada S, Iwazaki S, Nakamura S, et al. Pancreaticojejunostomysecuring technique: ducttomucous anastomosis by continuous running suture and parachuting using no filament absorbed thread [Ｊ]. J Am Coll Surg, 1997; 185(2)∶190.
21.	趙玉沛，蔡力行，鐘守先. 胰管空腸殘端套入法預防Whipple術后胰瘺發生 [Ｊ].中華外科雜志，1993； 31（6）∶360.
22.	Delcore R, Thomas JH, Pierce GE, et al. Pancreatogastrostomy: a safe drainage procedure after pancreaticoduodenectomy [Ｊ]. Surgery, 1990; 108(6)∶641.
23.	Sikora SS, Posenr MC. Management of the pancreatic stump following pancreaticoduodenectomy [Ｊ]. Br J Surg, 1995; 82(12)∶1590.
24.	DiCarlo V, Chiesa K, Pontiroli AE, et al. Pancreaticoduodenectomy with occlusion of the residual stump by neoprene injection [Ｊ]. World J Surg, 1989: 13(11)∶1102.
25.	Tashior S, Murata E, Hiraoka T, et al. New technique for pancreaticojejunostomy using a biological adhesive [Ｊ]. Br J Surg, 1987; 74(4)∶392.
26.	Brooks JR, Brooks DC, Levine JD, et al. Total pancreatectomy for duct cell carcinoma of the pancreas [Ｊ]. Ann Surg, 1989; 209(4)∶405.
27.	Sarr MG, Behrns KE, Van heerden JA, et al. Total pancreatectomy: an objective analysis of its use in pancreatic cancer [Ｊ]. Hepatogastroenterology, 1993; 40(4)∶418.
28.	Pederzoli P, Bassi C, Falconi M, et al. Efficacy of octreotied in the prevention of complications of elective pancreatic surgery [Ｊ]. Br J Surg, 1994; 81(3)∶265.
29.	Montorsi M, Zago M, Mosca F, et al. Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: a prospective, controlled, randomized trial [Ｊ]. Surgery, 1995; 117(1)∶26.
30.	Lowy AM, Lee JF, Pisters PWT. Prospective, randomized trial of octreotide to prevent pancreatic fistula after pancreaticoduodenectomy for malignant disease [Ｊ]. Ann Surg, 1997; 226(6)∶632.

1. Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes [Ｊ]. Ann Surg, 1997; 226(3)∶248.
2. Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 222(5)∶580.
3. Staley CA, Lee JE, Cleary KR, et al. Preoperative chemoradiation, pancreaticoduodenectomy, and intraoperative radiation therapy for adenocarcinoma of pancreatic head [Ｊ]. Am J Surg, 1996; 171(1)∶118.
4. Matsumoto Y, Fujii H, Miura K, et al. Successful pancreatojejunal anastomosis for pancreaticoduodenectomy [Ｊ]. Surg Gynecol Obstet, 1992; 175(5)∶555.
5. Marcus ST, Cohen H, Ranson JHC, et al. Optimal management of the pancreatic remnant after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 221(6)∶635.
6. Tsuji M, Kimura H, Konixhi K, et al. Management of continuous anastomosis of pancreatic duct and jejunal mucous after pancreaticoduodenectomy: historical study of 300 patients [Ｊ]. Surgery, 1998; 123(6)∶617.
7. Bottger TC, Juniner T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: critical analysis of 221 resections [Ｊ]. World J Surg, 1999; 23(2)∶164.
8. Bottger TC, Juniner T. Treatment of tumors of the pancreatic head with suspected but unproved malignancy: is a nihilistic approach justified [Ｊ]. World J Surg, 1999; 23(2)∶158.
9. Berberat PO, Friess H, Kleeff J, et al. Prevention and treatment of complications in pancreatic cancer surgery [Ｊ]. Dig Surg, 1999; 16(4)∶327.
10. Baumel H, Huguier JC, Manderscheid JM. Results of resection of cancer of exocrine pancreas: a study from the French association of surgery [Ｊ]. Br J Surg, 1994; 81(1)∶102.
11. Sauvanet A, Belghiti J. Prevention of pancreatic fistula after cephalic duodenopancreatectomy [Ｊ]. Ann Chir, 1999; 53(7)∶612.
12. Bartoli FG, Amonet GB, Ravera G, et al. Pancreatic fistula and relative mortality in malignant disease after pancreaticoduodenectomy. Review and statistical meta analysis regarding 15 years of literature [Ｊ]. Anticancer Res, 1991; 65(11)∶1831.
13. 張志偉，蔡中瑞，何柏威，等. 胰十二指腸切除術后并發胰瘺的預防 [Ｊ]. 中華外科雜志，1997； 35（3）∶192.
14. 杜春淵，汪俊堂. 空腸漿肌袖與胰腺端端吻合防止胰十二指腸切除術后胰瘺技術 [Ｊ]. 當代醫師雜志， 1996； 1（5）∶50.
15. 岳茂興，李學彪，張圭顯. 胰空腸套入荷包縫合完全胰液外引流術預防胰十二指腸切除術后胰瘺 [Ｊ]. 中華外科雜志， 1997； 35（6）∶ 370.
16. 彭淑牖，吳育連，彭承宏，等. 捆綁式胰腸吻合術（附28例報告） [Ｊ]. 中華外科雜志， 1997； 35（3）∶158.
17. 彭淑牖，牟一平，江獻川，等. 胰斷端空腸漿肌鞘內套入吻合術（附11例報告） [Ｊ]. 中國實用外科雜志，1996； 16（10）∶12.
18. 彭淑牖，吳育連，彭承宏，等. 一種確保不發生胰瘺的術式——捆綁式胰腸吻合術 [Ｊ]. 普外基礎與臨床雜志，1997； 4（4）∶ 242.
19. Grace PA, Pitt HA, Tompkins RK, et al. Decreased mobility and mortality after pancreaticoduodenectomy [Ｊ]. Am J Surg, 1986; 151(2)∶141.
20. Ohwada S, Iwazaki S, Nakamura S, et al. Pancreaticojejunostomysecuring technique: ducttomucous anastomosis by continuous running suture and parachuting using no filament absorbed thread [Ｊ]. J Am Coll Surg, 1997; 185(2)∶190.
21. 趙玉沛，蔡力行，鐘守先. 胰管空腸殘端套入法預防Whipple術后胰瘺發生 [Ｊ].中華外科雜志，1993； 31（6）∶360.
22. Delcore R, Thomas JH, Pierce GE, et al. Pancreatogastrostomy: a safe drainage procedure after pancreaticoduodenectomy [Ｊ]. Surgery, 1990; 108(6)∶641.
23. Sikora SS, Posenr MC. Management of the pancreatic stump following pancreaticoduodenectomy [Ｊ]. Br J Surg, 1995; 82(12)∶1590.
24. DiCarlo V, Chiesa K, Pontiroli AE, et al. Pancreaticoduodenectomy with occlusion of the residual stump by neoprene injection [Ｊ]. World J Surg, 1989: 13(11)∶1102.
25. Tashior S, Murata E, Hiraoka T, et al. New technique for pancreaticojejunostomy using a biological adhesive [Ｊ]. Br J Surg, 1987; 74(4)∶392.
26. Brooks JR, Brooks DC, Levine JD, et al. Total pancreatectomy for duct cell carcinoma of the pancreas [Ｊ]. Ann Surg, 1989; 209(4)∶405.
27. Sarr MG, Behrns KE, Van heerden JA, et al. Total pancreatectomy: an objective analysis of its use in pancreatic cancer [Ｊ]. Hepatogastroenterology, 1993; 40(4)∶418.
28. Pederzoli P, Bassi C, Falconi M, et al. Efficacy of octreotied in the prevention of complications of elective pancreatic surgery [Ｊ]. Br J Surg, 1994; 81(3)∶265.
29. Montorsi M, Zago M, Mosca F, et al. Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: a prospective, controlled, randomized trial [Ｊ]. Surgery, 1995; 117(1)∶26.
30. Lowy AM, Lee JF, Pisters PWT. Prospective, randomized trial of octreotide to prevent pancreatic fistula after pancreaticoduodenectomy for malignant disease [Ｊ]. Ann Surg, 1997; 226(6)∶632.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Current Status of Prevention of Pancreatic Fistula after Pancreaticoduodenectomy

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