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Abstract
Pancreatic fistula represents the most common and dangerous complication following surgery for pancreatic cancer. The development of a fistula significantly worsens both the immediate and long-term outcomes of treating this condition and reduces the quality of life of a patient. This paper highlights the main publications that study pancreatic fistulas after pancreatoduodenectomy. It emphasizes the concept and modern classification of pancreatic fistula, explores the possibilities of predicting this complication, and reviews methods for its prevention and treatment. We have investigated the role of instrumental treatment methods in predicting fistula formation after surgery and their correlation with clinical data. The discussion includes various conservative and surgical methods for preventing fistulas and examines the role of creating an external vesungostomy. The paper also describes the main methods for treating pancreatic fistulas. The causes and mechanisms of pancreatic fistula are diverse, and its consequences can have a significant negative impact on the length and quality of life of patients. Therefore, particular attention should focus on predicting pancreatic fistula and using methods to prevent it.
References
Huang J., Lok V., Ngai C.H., et al. Worldwide burden of, risk factors for, and trends in pancreatic cancer. Gastroenterology. 2021; 160(3): 744-754.-DOI: https://doi.org/10.1053/j.gastro.2020.10.007.
Wang X., Cai Y., Jiang J., Peng B. Laparoscopic pancreaticoduodenectomy: outcomes and experience of 550 patients in a single institution. Ann Surg Oncol. 2020; 27(11): 4562-4573.-DOI: https://doi.org/10.1245/s10434-020-08533-3.
Котельников А.Г., Патютко Ю.И., Подлужный Д.В., et al. Панкреатодигестивный анастомоз – ключ к благоприятному исходу панкреатодуоденальной резекции. Анналы хирургической гепатологии. 2022; 27(3): 92-99.-DOI: https://doi.org/10.16931/1995-5464.2022-3-92-99. [Kotelnikov A.G., Patyutko Yu.I., Podluzhny D.V., et al. Pancreatodigestive anastomosis: the key to a favorable outcome of pancreaticoduodenal resection. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2022; 27(3): 92-99.-DOI: https://doi.org/10.16931/1995-5464.2022-3-92-99. (In Rus)].
Xiang C., Chen Y., Liu X., et al. Prevention and treatment of grade c postoperative pancreatic fistula. J Clin Med. 2022; 11: 7516.-DOI: https://doi.org/10.3390/jcm11247516.
Ma T., Bai X., Chen W., et al. Surgical management and outcome of grade-C pancreatic fistulas after pancreaticoduodenectomy: A retrospective multicenter cohort study. Int J Surg. 2019; 68: 27-34.-DOI: https://doi.org/10.1016/j.ijsu.2019.05.019.
Дронов А.И., Ковальская И.А., Земсков С.В., et al. Влияние послеоперационных панкреатических свищей на выживаемость пациентов с раком головки поджелудочной железы после панкреатодуоденальной резекции. Материалы ХХМ Международного конгресса Ассоциации гепатопанкреатобилиарных хирургов стран СНГ «Актуальные проблемы гепатопанкреатобилиарной хирургии». 2017; 184-185. [Dronov A.I., Kovalskaya I.A., Zemskov S.V., et al. The influence of postoperative pancreatic fistulas on the survival of patients with pancreatic head cancer after pancreaticoduodenal resections. Proceedings of XXX International Congress of the Association of Hepatopancreatobiliary Surgeons of the CIS countries ‘Actual problems of hepatopancreatobiliary surgery’. 2017; 184-185. (In Rus)].
Bassi C., Marchegiani G., Dervenis C., et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery. 2017; 161(3): 584-591.-DOI: https://doi.org/10.1016/j.surg.2016.11.014.
Ахтанин Е.А., Кригер А.Г. Причины возникновения и профилактика панкреатических свищей после резекционных операций на поджелудочной железе. Хирургия. Журнал им. Н.И. Пирогова. 2014; (5): 79‑83. [Akhtanin EA, Kriger AG. Causes and prevention of pancreatic fistulas after pancreas resection. Pirogov Russian Journal of Surgery. 2014; (5): 79‑83. (In Rus)].
Callery M.P., Pratt W.B., Kent T.S., et al. A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg. 2013; 216(1): 1-14.-DOI: https://doi.org/10.1016/j.jamcollsurg.2012.09.002.
Kantor O., Talamonti M.S., Pitt H.A., et al. Using the NSQIP pancreatic demonstration project to derive a modified fistula risk score for preoperative risk stratification in patients undergoing pancreaticoduodenectomy. J Am Coll Surg. 2017; 224(5): 816-825.-DOI: https://doi.org/10.1016/j.jamcollsurg.2017.01.054.
Miller B.C., Christein J.D., Behrman S.W., et al. A multi-institutional external validation of the fistula risk score for pancreatoduodenectomy. J Gastrointest Surg. 2014; 18(1): 172-79; discussion 179-80.-DOI: https://doi.org/10.1007/s11605-013-2337-8.
Shubert C.R., Wagie A.E., Farnell M.B., et al. Clinical risk score to predict pancreatic fistula after pancreatoduodenectomy: independent external validation for open and laparoscopic approaches. J Am Coll Surg. 2015; 221(3): 689-98.-DOI: https://doi.org/10.1016/j.jamcollsurg.2015.05.011.
McMillan M.T., Soi S., Asbun H.J., et al. Risk-adjusted outcomes of clinically relevant pancreatic fistula following pancreatoduodenectomy: a model for performance evaluation. Ann Surg. 2016; 264(2): 344-52.-DOI: https://doi.org/10.1097/SLA.0000000000001537.
Кригер А.Г., Горин Д.С., Калдаров А.Р., Галкин Г.В. Профилактика панкреатического свища после панкреатодуоденальной резекции. Хирургия. Журнал им. Н.И. Пирогова. 2020; 11: 61-65.-DOI: https://doi.org/10.17116/hirurgia202011161. [Kriger A.G., Gorin D.S., Kaldarov A.R., Galkin G.V. Prevention of pancreatic fistula after pancreatoduodenectomy. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im N.I. Pirogova. 2020; 11: 61-65.-DOI: https://doi.org/10.17116/hirurgia202011161. (In Rus)].
Tomioka A., Shimizu T., Kagota S., et al. Association between neoadjuvant chemoradiotherapy and intractable serous ascites after pancreaticoduodenectomy for pancreatic cancer. Ann Surg Oncol. 2021; 28(7): 3789-3797.-DOI: https://doi.org/10.1245/s10434-020-09401-w.
Kamarajah S.K., Bundred J.R., Boyle C., et al. Impact of neoadjuvant therapy on post-operative pancreatic fistula: a systematic review and meta-analysis. ANZ J Surg. 2020; 90(11): 2201-2210.-DOI: https://doi.org/10.1111/ans.15885.
Zettervall S.L., Ju T., Holzmacher J.L., et al. Neoadjuvant radiation is associated with fistula formation following pancreaticoduodenectomy. J Gastrointest Surg. 2018; 22(6): 1026-1033.-DOI: https://doi.org/10.1007/s11605-018-3725-x.
Гальчина Ю.С., Кармазановский Г.Г., Кондратьев Е.В., et al. Возможность компьютерной томографии с контрастным усилением в оценке объема культи поджелудочной железы при панкреатодуоденальной резекции. Хирургия. Журнал им. Н.И. Пирогова. 2020; 6: 31-37.-DOI: https://doi.org/10.17116/hirurgia202006131. [Galchina Yu.S., Karmazanovsky G.G., Kondratyev E.V., et al. Contrast-enhanced computed tomography in evaluation of pancreatic stump volume in pancreaticoduodenectomy. Pirogov Russian Journal of Surgery = Khirurgiya Zhurnal im NI Pirogova. 2020; 6: 31-37.-DOI: https://doi.org/10.17116/hirurgia202006131. (In Rus)].
Гальчина Ю.С., Кармазановский Г.Г., Калинин Д.В., et al. Панкреатический свищ при проксимальной резекции поджелудочной железы: корреляция компьютерно-томографических и морфологических предикторов. Медицинская визуализация. 2020; 24(1): 29-38.-DOI: https://doi.org/10.24835/1607-0763-2020-1-29-38. [Galchina Yu.S., Karmazanovsky G.G., Kalinin D.V., et al. Pancreatic fistula in proximal pancreas resection: correlation of computed tomography and morphological predictors. Medical Visualization. 2020; 24 (1): 29-38.-DOI: https://doi.org/10.24835/1607-0763-2020-1-29-38. (In Rus)].
Колесников Е.Н., Иозефи Д.Я., Кит О.И., Максимов А.Ю. Значение магнитно резонансной томографии в диагностике и прогнозе течения раннего послеоперационного периода при хирургическом лечении рака поджелудочной железы. Южно-Российский онкологический журнал. 2023; 4(4): 32-43.-DOI: https://doi.org/10.37748/2686-9039-2023-4-4-4.-URL: https://elibrary.ru/hetxqy. [Kolesnikov E.N., Iozefi D.Ya., Kit O.I., Maksimov A.Yu. Magnetic resonance imaging relevance in diagnosis and prognosis of early postoperative period following pancreatic cancer surgical treatment. South Russian Journal of Cancer. 2023; 4(4): 32-43.-DOI: https://doi.org/10.37748/2686-9039-2023-4-4-4.-URL: https://elibrary.ru/hetxqy. (In Rus)].
Данилов М.В. Выбор оптимального метода обработки культи поджелудочной железы после панкреатодуоденальной резекции. Анналы хирургической гепатологии. 2013; 18(3): 40-45. [Danilov M.V. Selection of the optimal method for treating the pancreatic stump after pancreatoduodenal resection. Annals of Surgical Hepatology = Annaly hirurgicheskoj gepatologii. 2013; 18(3): 40-45. (In Rus)].
Malgras B., Dokmak S., Aussilhou B., et al. Management of postoperative pancreatic fistula after pancreaticoduodenectomy. J Visc Surg. 2023; 160(1): 39-51.-DOI: https://doi.org/10.1016/j.jviscsurg.2023.01.002.
Торба А.В. Факторы, влияющие на время заживления послеоперационного панкреатического свища у пациентов, перенесенных панкреатодуоденэктомию. Новообразование. 2022; 14(3): 118-122. [Torba A.V. Factors influencing the healing time of postoperative pancreatic fistula in patients undergoing pancreaticoduodenectomy. Neoplasm = Novoobrazovanie. 2022; 14(3): 118-122. (In Rus)].
Степан Е.В., Ермолов А.С., Рогаль М.Л., Тетерин Ю.С. Принципы лечения больных с наружными панкреатическими свищами (с комментарием). Хирургия. Журнал им. НИ Пирогова. 2017; (3): 42-49. [Stepan E.V., Ermolov A.S., Rogal M.L., Teterin Yu.S. External pancreatic fistulas management. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im N.I. Pirogova. 2017; (3): 42‑49. (In Rus)].
Koti R.S., Gurusamy K.S., Fusai G., Davidson B.R. Meta-analysis of randomized controlled trials on the effectiveness of somatostatin analogues for pancreatic surgery: a Cochrane review. HPB (Oxford). 2010; 12(3): 155-65.-DOI: https://doi.org/10.1111/j.1477-2574.2010.00157.x.
Jin K., Zhou H., Zhang J., et al. Systematic review and meta-analysis of somatostatin analogues in the prevention of postoperative complication after pancreaticoduodenectomy. Dig Surg. 2015; 32(3): 196-207.-DOI: https://doi.org/10.1159/000381032.
El Nakeeb A., El Gawalby A., A Ali M., et al. Efficacy of octreotide in the prevention of complications after pancreaticoduodenectomy in patients with soft pancreas and non-dilated pancreatic duct: A prospective randomized trial. Hepatobiliary Pancreat Dis Int. 2018; 17(1): 59-63.-DOI: https://doi.org/10.1016/j.hbpd.2018.01.015.
Torres O.J.M., Moraes-Junior J.M.A., Fernandes E.S.M., Hackert T. Surgical management of postoperative grade c pancreatic fistula following pancreatoduodenectomy. Visc Med. 2022; 38(4): 233-242.-DOI: https://doi.org/10.1159/000521727.
Гоев А.А., Берелавичус С.В., Карчаков С.С., Галкин Г.В. Послеоперационные кровотечения в хирургии поджелудочной железы. Хирургия. Журнал им. Н.И. Пирогова. 2021; 1: 77-82.-DOI: https://doi.org/10.17116/hirurgia202101177. [Goev A.A., Berelavichus S.V., Karchakov S.S., Galkin G.V. Postpancreatectomy hemorrhage. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im N.I. Pirogova. 2021; (1): 77‑82. (In Rus)].
Palumbo D., Tamburrino D., Partelli S., et al. Before sentinel bleeding: early prediction of postpancreatectomy hemorrhage (PPH) with a CT-based scoring system. Eur Radiol. 2021; 31(9): 6879-6888.-DOI: https://doi.org/10.1007/s00330-021-07788-y.
Montorsi R.M., Zonderhuis B.M., Daams F., et al. Treatment strategies to prevent or mitigate the outcome of post-pancreatectomy hemorrhage (PPH): a review of randomized trials. Int J Surg. 2023: 10-1097.-DOI: https://doi.org/10.1097/JS9.0000000000000876.
Balzano G., Pecorelli N., Piemonti L., et al. Relaparotomy for a pancreatic fistula after a pancreaticoduodenectomy: a comparison of different surgical strategies. HPB (Oxford). 2014; 16(1): 40-5.-DOI: https://doi.org/10.1111/hpb.12062.
Ribero D., Amisano M., Zimmitti G., et al. External tube pancreatostomy reduces the risk of mortality associated with completion pancreatectomy for symptomatic fistulas complicating pancreaticoduodenectomy. J Gastrointest Surg. 2013; 17(2): 332-8.-DOI: https://doi.org/10.1007/s11605-012-2100-6.
Paye F., Lupinacci R.M., Kraemer A., et al. Surgical treatment of severe pancreatic fistula after pancreaticoduodenectomy by wirsungostomy and repeat pancreatico-jejunal anastomosis. Am J Surg. 2013; 206(2): 194-201.-DOI: https://doi.org/10.1016/j.amjsurg.2012.10.039.
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