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Schwartz's Principles of Surgery, 8e
10/31/2007: Preventing Pancreatic Leak
Dana K. Andersen
Chief of Surgical Services at the Johns Hopkins Bayview Medical Center, and Vice-Chairman of the Department of Surgery at Johns Hopkins
Topics Discussed: anastomotic leak; pancreatic diseases; pancreaticoduodenectomy; pancreaticojejunostomy; procedures on pancreas.
Excerpt:
"The identification of a method for creating an anastomosis to the transected pancreas which eliminates the possibility of leak is a tantalizing goal which has fascinated pancreatic surgeons for decades. Major series of pancreaticoduodenectomy report leaks rates which range between 10-28%, and this seems to be confirmed worldwide. It is understood that the risk of leak is greater with soft or "normal" glands but the risk of leak from the end-on pancreatico-jejunal anastomosis is a nemesis from which no pancreatic surgeon has been able to escape...."
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