The Role of Pancreatic Leakage in Rising of Complications Linked to Pancreatic Surgery

Introduction: An analysis of the role of pancreatic leakage in rising of complications linked to pancreatic surgery. Methods: From ’89 to ’05, 137 consecutive patients underwent surgical procedure for pancreatic cancer at our Department. We per- formed 76 pancreaticoduodenectomy (PD) and 26 distal pancreasec- tomy (DP); we recorded results of only 102 patients who underwent PD or DP. The surgical reconstruction after PD was as follows: 11 manual non-absorbable stitches closure of the main duct, 24 closure of the main duct with linear stapler, 17 temporary occlusion of the main duct with neoprene glue and 24 duct-to-mucosa anastomosis. Results: Morbidity rate was 60%, caused by: pancreatic leakage (48%) haemorrhagic complication (10%) and infectious complication (15%). At the multivariate analysis complications were linked to: age 70 years (p 0.0139), T3 (p 0.031) and N2 (p 0.000001), sur- gical procedure (PD, p 0.0018) and pancreatic residual treatment (duct-to-mucosa anastomosis p 0.003 and stapler closure p 0.002). Haemorragic complication, biliary anastomosis leakage and infectious complication were consequences of pancreatic leakage (all p 0.025). Conclusion: On the ground of our data we believe that manual non-absorbable stitches closure of the main duct and temporary occlusion of the main duct with neoprene glue should be avoided in the reconstructive phase.