caa a22 4500 606248145 CHVBK 20210128101349.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s12262-015-1366-9 doi (NATIONALLICENCE)springer-10.1007/s12262-015-1366-9 Pancreatic Fistula and Delayed Gastric Emptying After Pancreatectomy: Where do We Stand? [Elektronische Daten] [Ammar Javed, Kanza Aziz, Fabio Bagante, Christopher Wolfgang] Pancreatic resection has become a feasible treatment of pancreatic neoplasms, and with improvements in surgical techniques and perioperative management, mortality associated with pancreatic surgery has decreased considerably. Despite this improvement, a high rate of complications is still associated with these procedures. Among these complications, delayed gastric emptying (DGE) and postoperative pancreatic fistula (POPF) have a substantial impact on patient outcomes and burden our healthcare system. Technical modifications and postoperative approaches have been proposed to reduce rates of both POPF and DGE in patients undergoing pancreatectomy; however, to date, their rates have remained unchanged. In the present study, we summarize the findings of the most significant studies that have investigated these complications. In particular, several studies focused on technical modifications including extent of dissection, stent placement, nature of anastomosis, type of reconstruction, and application of biological or non-biological agents to site of anastomosis. Moreover, postoperatively, drain placement, duration of drain usage, postoperative feeding, and use of pharmacological agents were studied to reduce rates of POPF and DGE. In this review, we summarize the most relevant literature on this fundamental aspect of pancreatic surgery. Despite studies identifying the potential benefit of technical modifications and postoperative approaches, these findings remain controversial and suggest need for further extensive investigation. Most importantly, we recommend that all surgeons performing these procedures base their practice on the most updated and highest available level of evidence. Association of Surgeons of India, 2015 Pancreatic surgery nationallicence Postoperative outcomes nationallicence Complications nationallicence Delayed gastric emptying nationallicence Postoperative pancreatic fistula nationallicence Javed Ammar Department of Surgery, Johns Hopkins Hospital, 685 Blalock, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut Aziz Kanza Department of Surgery, Johns Hopkins Hospital, 685 Blalock, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut Bagante Fabio Department of Surgery, Johns Hopkins Hospital, 685 Blalock, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut Wolfgang Christopher Department of Surgery, Johns Hopkins Hospital, 685 Blalock, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut Indian Journal of Surgery Springer India 77/5(2015-10-01), 409-425 0972-2068 77:5<409 2015 77 12262 https://doi.org/10.1007/s12262-015-1366-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-015-1366-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Javed Ammar Department of Surgery, Johns Hopkins Hospital, 685 Blalock, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Aziz Kanza Department of Surgery, Johns Hopkins Hospital, 685 Blalock, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Bagante Fabio Department of Surgery, Johns Hopkins Hospital, 685 Blalock, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Wolfgang Christopher Department of Surgery, Johns Hopkins Hospital, 685 Blalock, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77/5(2015-10-01), 409-425 0972-2068 77:5<409 2015 77 12262