From 1990 to 1993, 38 patients underwent pancreaticoduodenectomy (PD) at the Department of Surgery, Dong-A University Hospital with a operative mortality of 15.8%. the aim of sthis study was to evaluate the surgical complications and risk factors
of PD,
and present management strategy of pancreatic fistula complicated after this operation.
Mortality was increase significantly when the age was above 60 years, the operation was performed in a emergency situation, it was indicated by the pancreaticoduodenal injury, and the pancreatic fistula was complicated. The most catastropic
complication
following PD was pancreatic fistula secondary to failure of pancreaticojejunal anastomosis-five of 8 patients with pancreatic fistula died. The risk of pancreatic fistula was increased significantly when the operation was performed in a emergency
situation for pancreaticoduodenal injury and the pancreas was soft in consistency.
For the patient in whom the pancreaticojejunal anastomosis is far from satisfaction, consid eration could be given to perform total pancreatectomy to avoid potentially fatal pancreatic fistula. In addition, to minimize morbidity and mortality an
early
aggressive approach to the managment of the pancreatic fistula should be given when it is diagnosed postoperatively.
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