The pancreatic surgery can result in high postoperative morbidity rates. Pancreatic resections are among the major surgical procedures such as pancreaticoduodenectomy (PD), Puestow, Beger—Frey procedure,distal resection etc., with operative mortality rates less than 5%, showing a stable reduction, referred to the last two decades, but also a stable high morbidity rates (30-60%). Pancreatic fistula is the most relevant complication of pancreatic surgery. Other specific complications of pancreatic surgery may occur with variable incidence: delayed gastric emptying after PD, postoperative hemorrhage following pancreatic resection in the immediate postoperative period or delayed 10-15 days, gastrojejunal anastomotic fistula after PD, enteric fistula after laparostomies/relaparotomies as treatment of infected pancreatic necrosis, intrabdominal abscess following necrosectomy for infected pancreatic necrosis by acute pancreatitis or after pancreatico-jejunostomy. Biliary surgery presents very variable range of complexity. The bile duct injuries are the major complications of biliary surgery; their incidence, very frequently related to cholecystectomy,with open or laparoscopic approach, varies from 0,2% to 0,8%. These injuries can be recognized during operative procedures or in the postoperative period, early or late. In any case the biliary injury can be followed by long-term morbidity, multiple radiological and surgical therapeutical procedures and mortality. Other complications are the biliary strictures due to pathological evolution of bile duct injury or of bilio-digestive anastomosis. The evaluation of omogenous clinical cases of biliopancreatic surgery’s complications, from our experience, can allow us to clarify the choices of the treatments. Pancreatic and biliary surgical complications include an ample range of clinical conditions. This study reviews the more common postoperative pancreatic and biliary complications, their prevention and treatment.
A summary of immediate results in pancreatic and biliary surgery
Cianci P.;Tartaglia N.;Fersini A.;Ambrosi A.;Neri V.
2018-01-01
Abstract
The pancreatic surgery can result in high postoperative morbidity rates. Pancreatic resections are among the major surgical procedures such as pancreaticoduodenectomy (PD), Puestow, Beger—Frey procedure,distal resection etc., with operative mortality rates less than 5%, showing a stable reduction, referred to the last two decades, but also a stable high morbidity rates (30-60%). Pancreatic fistula is the most relevant complication of pancreatic surgery. Other specific complications of pancreatic surgery may occur with variable incidence: delayed gastric emptying after PD, postoperative hemorrhage following pancreatic resection in the immediate postoperative period or delayed 10-15 days, gastrojejunal anastomotic fistula after PD, enteric fistula after laparostomies/relaparotomies as treatment of infected pancreatic necrosis, intrabdominal abscess following necrosectomy for infected pancreatic necrosis by acute pancreatitis or after pancreatico-jejunostomy. Biliary surgery presents very variable range of complexity. The bile duct injuries are the major complications of biliary surgery; their incidence, very frequently related to cholecystectomy,with open or laparoscopic approach, varies from 0,2% to 0,8%. These injuries can be recognized during operative procedures or in the postoperative period, early or late. In any case the biliary injury can be followed by long-term morbidity, multiple radiological and surgical therapeutical procedures and mortality. Other complications are the biliary strictures due to pathological evolution of bile duct injury or of bilio-digestive anastomosis. The evaluation of omogenous clinical cases of biliopancreatic surgery’s complications, from our experience, can allow us to clarify the choices of the treatments. Pancreatic and biliary surgical complications include an ample range of clinical conditions. This study reviews the more common postoperative pancreatic and biliary complications, their prevention and treatment.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
