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Operative Complications and Their Management Following Resection for Pancreatic and Periampullary Cancers

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Surgery for Pancreatic and Periampullary Cancer

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Abstract

Surgical resection of pancreatic and periampullary tumors remains the only potentially curative therapy available to patients with these tumors. Pancreaticoduodenectomy (PD) is a complex operation and is associated with considerable morbidity, but low mortality when performed at high-volume centers. Improvements in surgical techniques and perioperative management have led to a significant decrease in the mortality; however the rate of postoperative complications remains high. Currently, approximately half of all patients undergoing PD experience postoperative complication. The most common complications include postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE) followed by surgical site infections (SSIs), and postpancreatectomy hemorrhage (PPH). Less common complications include biliary complications, chyle leakage, cardiac events, and pulmonary complications. These complications have been associated with impact on quality of life of patients, increased length of stay, delay in receipt of adjuvant chemotherapy, and increased healthcare costs. Multiple surgical and nonsurgical interventions have been proposed and studied to reduce the rate of these complications. In this chapter we discuss the literature available on prevention, early diagnosis, and management of these complications. We also list the currently active clinical trials being performed to study these complications further.

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Authors and Affiliations

  1. Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA

    Kanza Aziz M.D., Christopher L. Wolfgang M.D. Ph.D. & Ammar A. Javed M.D.

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  1. Kanza Aziz M.D.
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  2. Christopher L. Wolfgang M.D. Ph.D.
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  3. Ammar A. Javed M.D.
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Correspondence to Ammar A. Javed M.D. .

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  1. Chief Hepato-Pancreato-Biliary and Gastrointestinal Division, Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P., India

    Mallika Tewari

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Aziz, K., Wolfgang, C.L., Javed, A.A. (2018). Operative Complications and Their Management Following Resection for Pancreatic and Periampullary Cancers. In: Tewari, M. (eds) Surgery for Pancreatic and Periampullary Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-7464-6_24

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