Research Progress of Pancreatic Fistula Following Pancreaticoduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HEYong ,  ZHOUWen-ce , ZHANGHui

Department Ⅱ of General Surgery, The First Hospital of Lanzhou University; Hepatopancreatobiliary Surgery Institute of Gansu Province, Lanzhou 730000, Gansu Province, China;

Corresponding author：

ZHOUWen-ce, Email: zhouwc129@163.com

Keywords：

Pancreaticoduodenectomy; Pancreatic fistula; Preoperative biliary drainage; Prevention

DOI：

10.7507/1007-9424.20150398

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the prevention method for pancreatic fistula following pancreaticoduodenec-tomy. Method Literatures related to the prevention methods for postoperative pancreatic fistula at home and abroad in recent years were retrieved and summarized. Results The pancreatic fistula was a common complication following pancreaticoduodenectomy. It was mainly caused by preoperative continuous high jaundice, selection of intraoperative anastomosis, and early postoperative pancreatic juice secretion. Trypsinogen was activated by alkaline intestinal juice and then the nearby tissue was digested. Pancreatic juice flowed into abdominal cavity to digest the tissue, then caused serious complications or even death. Through the prevention of drugs, preoperative biliary drainage and intraoperative anastomosis, etc., the incidence of postoperative pancreatic fistula was slightly decreased. Conclusion The prevention for postoperative pancreatic fistula is an integrated process, and it needs to be ran through the whole perioperative period.

Citation： HEYong, ZHOUWen-ce, ZHANGHui. Research Progress of Pancreatic Fistula Following Pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(12): 1530-1534. doi: 10.7507/1007-9424.20150398 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin, 2015, 65(1): 5-29.
2.	Koti RS, Gurusamy KS, Fusai G, et al. Meta-analysis of randomized controlled trials on the effectiveness of somatostatin analogues for pancreatic surgery: a Cochrane review. HPB(Oxford), 2010, 12(3): 155-165.
3.	Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group(ISGPF) definition. Surgery, 2005, 138(1): 8-13.
4.	Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg, 1995, 222(4): 580-592.
5.	Poon RT, Lo SH, Fong D, et al. Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy. Am J Surg, 2002, 183(1): 42-52.
6.	Bartoli FG, Arnone GB, Ravera G, et al. Pancreatic fistula and rela-tive mortality in malignant disease after pancreaticoduodenectomy. Review and statistical meta-analysis regarding 15 years of literature. Anticancer Res, 1992, 11(5): 1831-1848.
7.	Yeo CJ, Cameron JL, Lillemoe KD, et al. Does prophylactic octreo-tide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective rando-mized placebo-controlled trial. Ann Surg, 2000, 232(3): 419-429.
8.	Mimatsu K, Oida T, Kano H, et al. Protection of major vessels and pancreaticogastrostomy using the falciform ligament and greater omentum for preventing pancreatic fistula in soft pancreatic texture after pancreaticoduodenectomy. Hepatogastroenterology, 2011, 58(110/111): 1782-1786.
9.	Kawai M, Kondo S, Yamaue H, et al. Predictive risk factors for clinically relevant pancreatic fistula analyzed in 1 239 patients with pancreaticoduodenectomy: multicenter data collection as a project study of pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci, 2011, 18(4): 601-608.
10.	Casadei R, Ricci C, Taffurelli G, et al. Are there preoperative factors related to a "soft pancreas" and are they predictive of pancreatic fistulas after pancreatic resection? Surg Today, 2015, 45(6): 708-714.
11.	Fernández-Cruz L, Jiménez Chavarría E, Taurà P, et al. Prospective randomized trial of the effect of octreotide on pancreatic juice output after pancreaticoduodenectomy in relation to histological diagnosis, duct size and leakage. HPB(Oxford), 2013, 15(5): 392-399.
12.	Penumadu P, Barreto SG, Goel M, et al. Pancreatoduodenectomy－preventing complications. Indian J Surg Oncol, 2015, 6(1): 6-15.
13.	Yeh TS, Jan YY, Jeng LB, et al. Pancreaticojejunal anastomotic leak after pancreaticoduodenectomy-multivariate analysis of perioperative risk factors. J Surg Res, 1997, 67(2): 119-125.
14.	Liu QY, Zhang WZ, Xia HT, et al. Analysis of risk factors for posto-perative pancreatic fistula following pancreaticoduodenectomy. World J Gastroenterol, 2014, 20(46): 17491-17497.
15.	周先亭, 孙立臣, 曹宗献, 等.生长抑素预防胰十二指肠切除术后胰瘘的对比研究.肝胆外科杂志, 2001, 9(6): 436-437.
16.	Klempa I, Schwedes U, Usadel KH. Prevention of postoperative pancreatic complications following duodenopancreatectomy using somatostatin. Chirurg, 1979, 50(7): 427-431.
17.	Friess H, Beger HG, Sulkowski U, et al. Randomized controlled multicentre study of the prevention of complications by octreotide in patients undergoing surgery for chronic pancreatitis. Br J Surg, 1995, 82(9): 1270-1273.
18.	Gouillat C, Chipponi J, Baulieux J, et al. Randomized controlled multicentre trial of somatostatin infusion after pancreaticoduodenec-tomy. Br J Surg, 2001, 88(11): 1456-1462.
19.	Allen PJ, Gönen M, Brennan MF, et al. Pasireotide for postoperative pancreatic fistula. N Engl J Med, 2014, 370(21): 2014-2022.
20.	Gurusamy KS, Koti R, Fusai G, et al. Somatostatin analogues for pancreatic surgery. Cochrane Database Syst Rev, 2013, 4: CD008370.
21.	何平, 梁杰雄, 伍冀湘, 等.生长抑素14肽对胰十二指肠切除术后胰瘘的预防作用.中国临床药理学杂志, 2012, 28(2): 93-95.
22.	王维国, 付岚, 张美玲, 等.胰腺术后胰瘘及生长抑素对其预防和治疗价值的研究进展.肝胆胰外科杂志, 2012, 24(2): 173-175.
23.	McMillan MT, Christein JD, Callery MP, et al. Prophylactic octreotide for pancreatoduodenectomy: more harm than good? HPB(Oxford), 2014, 16(10): 954-962.
24.	Malleo G, Mazzarella F, Malpaga A, et al. Diabetes mellitus does not impact on clinically relevant pancreatic fistula after partial pancreatic resection for ductal adenocarcinoma. Surgery, 2013, 153(5): 641-650.
25.	Mathur A, Pitt HA, Marine M, et al. Fatty pancreas: a factor in postoperative pancreatic fistula. Ann Surg, 2007, 246(6): 1058-1064.
26.	王长友, 陈永平.梗阻性黄疸肝细胞损伤机制.中国综合临床, 2004, 20(8): 93-95.
27.	牟一平, 彭淑牖.重视梗阻性黄疸时胆汁酸的毒性作用.中国实用外科杂志, 1996, 16(1): 16-17.
28.	董家鸿, 曾永毅.梗阻性黄疸研究热点与难点.中国实用外科杂志, 2007, 27(10): 768-770.
29.	Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
30.	Van Der Gaag NA, Rauws EA, Van Eijck CH, et al. Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med, 2010, 362(2): 129-137.
31.	Tsai YF, Shyu JF, Chen TH, et al. Effect of preoperative biliary drainage on surgical outcome after pancreaticoduodenectomy. Hepatogastroenterology, 2006, 53(72): 823-827.
32.	Tomazic A, Pleskovic A. Surgical outcome after pancreatoduodenec-tomy: effect of preoperative biliary drainage. Hepatogastroenterology, 2006, 53(72): 944-946.
33.	Bhati CS, Kubal C, Sihag PK, et al. Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy. World J Gastroenterol, 2007, 13(8): 1240-1242.
34.	Arkadopoulos N, Kyriazi MA, Papanikolaou IS, et al. Preoperative biliary drainage of severely jaundiced patients increases morbidity of pancreaticoduodenectomy: results of a case-control study. World J Surg, 2014, 38(11): 2967-2972.
35.	Morris S, Gurusamy KS, Sheringham J, et al. Cost-effectiveness of preoperative biliary drainage for obstructive jaundice in pancreatic and periampullary cancer. J Surg Res, 2015, 193(1): 202-209.
36.	田伏洲, 石力, 汤礼军, 等.胰头癌术前减黄指征的前瞻性研究.中华外科杂志, 2006, 44(23): 1614-1616.
37.	Kim DJ, Paik KY, Kim W, et al. The effect of modified pancreatico-jejunostomy for reducing the pancreatic fistula after pancreatico-duodenectomy. Hepatogastroenterology, 2014, 61(133): 1421-1425.
38.	Ji W, Shao Z, Zheng K, et al. Pancreaticojejunostomy with double-layer continuous suturing is associated with a lower risk of pancreatic fistula after pancreaticoduodenectomy: a comparative study. Int J Surg, 2014, 13: 84-89.
39.	Han HJ, Choi SB, Lee JS, et al. Reliability of continuous suture of pancreaticojejunostomy after pancreaticoduodenectomy. Hepato-gastroenterology, 2012, 58(112): 2132-2139.
40.	Hashimoto D, Chikamoto A, Ohmuraya M, et al. Pancreaticodiges-tive anastomosis and the postoperative management strategies to prevent postoperative pancreatic fistula formation after pancrea-ticoduodenectomy. Surg Today, 2014, 44(7): 1207-1213.
41.	Peng S, Mou Y, Cai X, et al. Binding pancreaticojejunostomy is a new technique to minimize leakage. Am J Surg, 2002, 183(3): 283-285.
42.	Berger AC, Howard TJ, Kennedy EP, et al. Does type of pancrea-ticojejunostomy after pancreaticoduodenectomy decrease rate of pancreatic fistula? A randomized, prospective, dual-institution trial. J Am Coll Surg, 2009, 208(5): 738-749.
43.	You D, Jung K, Lee H, et al. Comparison of different pancreatic anastomosis techniques using the definitions of the International Study Group of Pancreatic Surgery: a single surgeon's experience. Pancreas, 2009, 38(8): 896-902.
44.	Waugh JM, Clagett OT. Resection of the duodenum and head of the pancreas for carcinoma; an analysis of thirty cases. Surgery, 1946, 20(20): 224-232.
45.	McKay A, Mackenzie S, Sutherland FR, et al. Meta-analysis of pan-creaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy. Br J Surg, 2006, 93(8): 929-936.
46.	Ramesh H, Thomas PG. Pancreaticojejunostomy versus pancreatico-gastrostomy in reconstruction following pancreaticoduodenectomy.Aust N Z J Surg, 1990, 60(12): 973-976.
47.	Hallet J, Zih FS, Deobald RG, et al. The impact of pancreaticojejunos-tomy versus pancreaticogastrostomy reconstruction on pancreatic fistula after pancreaticoduodenectomy: meta-analysis of randomized controlled trials. HPB(Oxford), 2015, 17(2): 113-122.
48.	Zhang X, Ma L, Gao X, et al. Pancreaticogastrostomy versus pancrea-ticojejunostomy reconstruction after pancreaticoduodenectomy: a meta-analysis of randomized controlled trials. Surg Today, 2014, 45(5): 585-594.
49.	Ma JP, Peng L, Qin T, et al. Meta-analysis of pancreaticoduodenec-tomy prospective controlled trials: pancreaticogastrostomy versus pancreaticojejunostomy reconstruction. Chin Med J(Engl), 2012, 125(21): 3891-3897.
50.	Xiong JJ, Tan CL, Szatmary P, et al. Meta-analysis of pancreaticogas-trostomy versus pancreaticojejunostomy after pancreaticoduodenec-tomy. Br J Surg, 2014, 101(10): 1196-1208.
51.	Ma S, Li Q, Dai W, et al. Pancreaticogastrostomy versus pancreati-cojejunostomy. J Surg Res, 2014, 192(1): 68-75.
52.	Grendar J, Ouellet JF, Sutherland FR, et al. In search of the best reconstructive technique after pancreaticoduodenectomy: pancreaticojejunostomy versus pancreaticogastrostomy. Can J Surg, 2015, 58(3): 154-159.
53.	Biehl T, Traverso LW. Is stenting necessary for a successful pancreatic anastomosis? Am J Surg, 1992, 163(5): 530-532.
54.	王刚, 孙备, 姜洪池, 等.胰十二指肠切除术后早期胰管支撑管内引流及外引流的疗效比较.中华外科杂志, 2014, 52(5): 333-337.
55.	Pessaux P, Sauvanet A, Mariette C, et al. External pancreatic duct stent decreases pancreatic fistula rate after pancreaticoduodenec-tomy: prospective multicenter randomized trial. Ann Surg, 2011, 253(5): 879-885.
56.	Dugalic VD, Knezevic DM, Obradovic VN, et al. Drain amylase value as an early predictor of pancreatic fistula after cephalic duodenopancreatectomy. World J Gastroenterol, 2014, 20(26): 8691-8699.
57.	Sutcliffe RP, Battula N, Haque A, et al. Utility of drain fluid amylase measurement on the first postoperative day after pancreaticoduo-denectomy. World J Surg, 2012, 36(4): 879-883.
58.	Tsujie M, Nakamori S, Miyamoto A, et al. Risk factors of pancreatic fistula after pancreaticoduodenectomy-patients with low drain amylase level on postoperative day 1 are safe from developing pancreatic fistula. Hepatogastroenterology, 2013, 59(120): 2657-2660.
59.	Bruno O, Brancatelli G, Sauvanet A, et al. Utility of CT in the diagnosis of pancreatic fistula after pancreaticoduodenectomy in patients with soft pancreas. AJR Am J Roentgenol, 2009, 193(3): W175-W180.
60.	Raman SP, Horton KM, Cameron JL, et al. CT after pancreaticoduo-denectomy: spectrum of normal findings and complications. AJR Am J Roentgenol, 2013, 201(1): 2-13.
61.	Bhosale P, Fleming J, Balachandran A, et al. Complications of whipple surgery: imaging analysis. Abdom Imaging, 2013, 38(2): 273-284.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin, 2015, 65(1): 5-29.
2. Koti RS, Gurusamy KS, Fusai G, et al. Meta-analysis of randomized controlled trials on the effectiveness of somatostatin analogues for pancreatic surgery: a Cochrane review. HPB(Oxford), 2010, 12(3): 155-165.
3. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group(ISGPF) definition. Surgery, 2005, 138(1): 8-13.
4. Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg, 1995, 222(4): 580-592.
5. Poon RT, Lo SH, Fong D, et al. Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy. Am J Surg, 2002, 183(1): 42-52.
6. Bartoli FG, Arnone GB, Ravera G, et al. Pancreatic fistula and rela-tive mortality in malignant disease after pancreaticoduodenectomy. Review and statistical meta-analysis regarding 15 years of literature. Anticancer Res, 1992, 11(5): 1831-1848.
7. Yeo CJ, Cameron JL, Lillemoe KD, et al. Does prophylactic octreo-tide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective rando-mized placebo-controlled trial. Ann Surg, 2000, 232(3): 419-429.
8. Mimatsu K, Oida T, Kano H, et al. Protection of major vessels and pancreaticogastrostomy using the falciform ligament and greater omentum for preventing pancreatic fistula in soft pancreatic texture after pancreaticoduodenectomy. Hepatogastroenterology, 2011, 58(110/111): 1782-1786.
9. Kawai M, Kondo S, Yamaue H, et al. Predictive risk factors for clinically relevant pancreatic fistula analyzed in 1 239 patients with pancreaticoduodenectomy: multicenter data collection as a project study of pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci, 2011, 18(4): 601-608.
10. Casadei R, Ricci C, Taffurelli G, et al. Are there preoperative factors related to a "soft pancreas" and are they predictive of pancreatic fistulas after pancreatic resection? Surg Today, 2015, 45(6): 708-714.
11. Fernández-Cruz L, Jiménez Chavarría E, Taurà P, et al. Prospective randomized trial of the effect of octreotide on pancreatic juice output after pancreaticoduodenectomy in relation to histological diagnosis, duct size and leakage. HPB(Oxford), 2013, 15(5): 392-399.
12. Penumadu P, Barreto SG, Goel M, et al. Pancreatoduodenectomy－preventing complications. Indian J Surg Oncol, 2015, 6(1): 6-15.
13. Yeh TS, Jan YY, Jeng LB, et al. Pancreaticojejunal anastomotic leak after pancreaticoduodenectomy-multivariate analysis of perioperative risk factors. J Surg Res, 1997, 67(2): 119-125.
14. Liu QY, Zhang WZ, Xia HT, et al. Analysis of risk factors for posto-perative pancreatic fistula following pancreaticoduodenectomy. World J Gastroenterol, 2014, 20(46): 17491-17497.
15. 周先亭, 孙立臣, 曹宗献, 等.生长抑素预防胰十二指肠切除术后胰瘘的对比研究.肝胆外科杂志, 2001, 9(6): 436-437.
16. Klempa I, Schwedes U, Usadel KH. Prevention of postoperative pancreatic complications following duodenopancreatectomy using somatostatin. Chirurg, 1979, 50(7): 427-431.
17. Friess H, Beger HG, Sulkowski U, et al. Randomized controlled multicentre study of the prevention of complications by octreotide in patients undergoing surgery for chronic pancreatitis. Br J Surg, 1995, 82(9): 1270-1273.
18. Gouillat C, Chipponi J, Baulieux J, et al. Randomized controlled multicentre trial of somatostatin infusion after pancreaticoduodenec-tomy. Br J Surg, 2001, 88(11): 1456-1462.
19. Allen PJ, Gönen M, Brennan MF, et al. Pasireotide for postoperative pancreatic fistula. N Engl J Med, 2014, 370(21): 2014-2022.
20. Gurusamy KS, Koti R, Fusai G, et al. Somatostatin analogues for pancreatic surgery. Cochrane Database Syst Rev, 2013, 4: CD008370.
21. 何平, 梁杰雄, 伍冀湘, 等.生长抑素14肽对胰十二指肠切除术后胰瘘的预防作用.中国临床药理学杂志, 2012, 28(2): 93-95.
22. 王维国, 付岚, 张美玲, 等.胰腺术后胰瘘及生长抑素对其预防和治疗价值的研究进展.肝胆胰外科杂志, 2012, 24(2): 173-175.
23. McMillan MT, Christein JD, Callery MP, et al. Prophylactic octreotide for pancreatoduodenectomy: more harm than good? HPB(Oxford), 2014, 16(10): 954-962.
24. Malleo G, Mazzarella F, Malpaga A, et al. Diabetes mellitus does not impact on clinically relevant pancreatic fistula after partial pancreatic resection for ductal adenocarcinoma. Surgery, 2013, 153(5): 641-650.
25. Mathur A, Pitt HA, Marine M, et al. Fatty pancreas: a factor in postoperative pancreatic fistula. Ann Surg, 2007, 246(6): 1058-1064.
26. 王长友, 陈永平.梗阻性黄疸肝细胞损伤机制.中国综合临床, 2004, 20(8): 93-95.
27. 牟一平, 彭淑牖.重视梗阻性黄疸时胆汁酸的毒性作用.中国实用外科杂志, 1996, 16(1): 16-17.
28. 董家鸿, 曾永毅.梗阻性黄疸研究热点与难点.中国实用外科杂志, 2007, 27(10): 768-770.
29. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
30. Van Der Gaag NA, Rauws EA, Van Eijck CH, et al. Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med, 2010, 362(2): 129-137.
31. Tsai YF, Shyu JF, Chen TH, et al. Effect of preoperative biliary drainage on surgical outcome after pancreaticoduodenectomy. Hepatogastroenterology, 2006, 53(72): 823-827.
32. Tomazic A, Pleskovic A. Surgical outcome after pancreatoduodenec-tomy: effect of preoperative biliary drainage. Hepatogastroenterology, 2006, 53(72): 944-946.
33. Bhati CS, Kubal C, Sihag PK, et al. Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy. World J Gastroenterol, 2007, 13(8): 1240-1242.
34. Arkadopoulos N, Kyriazi MA, Papanikolaou IS, et al. Preoperative biliary drainage of severely jaundiced patients increases morbidity of pancreaticoduodenectomy: results of a case-control study. World J Surg, 2014, 38(11): 2967-2972.
35. Morris S, Gurusamy KS, Sheringham J, et al. Cost-effectiveness of preoperative biliary drainage for obstructive jaundice in pancreatic and periampullary cancer. J Surg Res, 2015, 193(1): 202-209.
36. 田伏洲, 石力, 汤礼军, 等.胰头癌术前减黄指征的前瞻性研究.中华外科杂志, 2006, 44(23): 1614-1616.
37. Kim DJ, Paik KY, Kim W, et al. The effect of modified pancreatico-jejunostomy for reducing the pancreatic fistula after pancreatico-duodenectomy. Hepatogastroenterology, 2014, 61(133): 1421-1425.
38. Ji W, Shao Z, Zheng K, et al. Pancreaticojejunostomy with double-layer continuous suturing is associated with a lower risk of pancreatic fistula after pancreaticoduodenectomy: a comparative study. Int J Surg, 2014, 13: 84-89.
39. Han HJ, Choi SB, Lee JS, et al. Reliability of continuous suture of pancreaticojejunostomy after pancreaticoduodenectomy. Hepato-gastroenterology, 2012, 58(112): 2132-2139.
40. Hashimoto D, Chikamoto A, Ohmuraya M, et al. Pancreaticodiges-tive anastomosis and the postoperative management strategies to prevent postoperative pancreatic fistula formation after pancrea-ticoduodenectomy. Surg Today, 2014, 44(7): 1207-1213.
41. Peng S, Mou Y, Cai X, et al. Binding pancreaticojejunostomy is a new technique to minimize leakage. Am J Surg, 2002, 183(3): 283-285.
42. Berger AC, Howard TJ, Kennedy EP, et al. Does type of pancrea-ticojejunostomy after pancreaticoduodenectomy decrease rate of pancreatic fistula? A randomized, prospective, dual-institution trial. J Am Coll Surg, 2009, 208(5): 738-749.
43. You D, Jung K, Lee H, et al. Comparison of different pancreatic anastomosis techniques using the definitions of the International Study Group of Pancreatic Surgery: a single surgeon's experience. Pancreas, 2009, 38(8): 896-902.
44. Waugh JM, Clagett OT. Resection of the duodenum and head of the pancreas for carcinoma; an analysis of thirty cases. Surgery, 1946, 20(20): 224-232.
45. McKay A, Mackenzie S, Sutherland FR, et al. Meta-analysis of pan-creaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy. Br J Surg, 2006, 93(8): 929-936.
46. Ramesh H, Thomas PG. Pancreaticojejunostomy versus pancreatico-gastrostomy in reconstruction following pancreaticoduodenectomy.Aust N Z J Surg, 1990, 60(12): 973-976.
47. Hallet J, Zih FS, Deobald RG, et al. The impact of pancreaticojejunos-tomy versus pancreaticogastrostomy reconstruction on pancreatic fistula after pancreaticoduodenectomy: meta-analysis of randomized controlled trials. HPB(Oxford), 2015, 17(2): 113-122.
48. Zhang X, Ma L, Gao X, et al. Pancreaticogastrostomy versus pancrea-ticojejunostomy reconstruction after pancreaticoduodenectomy: a meta-analysis of randomized controlled trials. Surg Today, 2014, 45(5): 585-594.
49. Ma JP, Peng L, Qin T, et al. Meta-analysis of pancreaticoduodenec-tomy prospective controlled trials: pancreaticogastrostomy versus pancreaticojejunostomy reconstruction. Chin Med J(Engl), 2012, 125(21): 3891-3897.
50. Xiong JJ, Tan CL, Szatmary P, et al. Meta-analysis of pancreaticogas-trostomy versus pancreaticojejunostomy after pancreaticoduodenec-tomy. Br J Surg, 2014, 101(10): 1196-1208.
51. Ma S, Li Q, Dai W, et al. Pancreaticogastrostomy versus pancreati-cojejunostomy. J Surg Res, 2014, 192(1): 68-75.
52. Grendar J, Ouellet JF, Sutherland FR, et al. In search of the best reconstructive technique after pancreaticoduodenectomy: pancreaticojejunostomy versus pancreaticogastrostomy. Can J Surg, 2015, 58(3): 154-159.
53. Biehl T, Traverso LW. Is stenting necessary for a successful pancreatic anastomosis? Am J Surg, 1992, 163(5): 530-532.
54. 王刚, 孙备, 姜洪池, 等.胰十二指肠切除术后早期胰管支撑管内引流及外引流的疗效比较.中华外科杂志, 2014, 52(5): 333-337.
55. Pessaux P, Sauvanet A, Mariette C, et al. External pancreatic duct stent decreases pancreatic fistula rate after pancreaticoduodenec-tomy: prospective multicenter randomized trial. Ann Surg, 2011, 253(5): 879-885.
56. Dugalic VD, Knezevic DM, Obradovic VN, et al. Drain amylase value as an early predictor of pancreatic fistula after cephalic duodenopancreatectomy. World J Gastroenterol, 2014, 20(26): 8691-8699.
57. Sutcliffe RP, Battula N, Haque A, et al. Utility of drain fluid amylase measurement on the first postoperative day after pancreaticoduo-denectomy. World J Surg, 2012, 36(4): 879-883.
58. Tsujie M, Nakamori S, Miyamoto A, et al. Risk factors of pancreatic fistula after pancreaticoduodenectomy-patients with low drain amylase level on postoperative day 1 are safe from developing pancreatic fistula. Hepatogastroenterology, 2013, 59(120): 2657-2660.
59. Bruno O, Brancatelli G, Sauvanet A, et al. Utility of CT in the diagnosis of pancreatic fistula after pancreaticoduodenectomy in patients with soft pancreas. AJR Am J Roentgenol, 2009, 193(3): W175-W180.
60. Raman SP, Horton KM, Cameron JL, et al. CT after pancreaticoduo-denectomy: spectrum of normal findings and complications. AJR Am J Roentgenol, 2013, 201(1): 2-13.
61. Bhosale P, Fleming J, Balachandran A, et al. Complications of whipple surgery: imaging analysis. Abdom Imaging, 2013, 38(2): 273-284.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research Progress of Pancreatic Fistula Following Pancreaticoduodenectomy

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