Pancreatic fistula and postoperative pancreatitis after pancreatoduodenectomy for pancreatic cancer

The most serious complication after pancreatoduodenectomy (PD) is pancreatic fistula (PF) typeC, either as a consequence or independently from postoperative pancreatitis (PP). Differentiating betweenthese two types of complications is often very difficult, if not impossible. The most significant factor in earlydiagnosis of PP after PD is an abrupt change in clinical status. In our retrospective study we also observedsignificantly higher levels of serum concentrations of CRP and AMS comparing to PF without PP. Basedon our findings, CT scan is not beneficial in the early diagnosis of PP. Meantime PF type C is indication tooperative revision with mostly drainage procedure which is obviously not much technically demanding, thereare no definite guidelines on how to proceed in PP. Therefore the surgeon’s experience determines not onlywhether PP will be diagnosed early enough and will be differentiated from PF without PP, but also whethera completion pancreatectomy will be performed in indicated cases.