Author Affiliation: Department of Surgery, Massachusetts General Hospital, Boston.
In this article, Dr Choi et al1 describe their recent experience with pancreaticoduodenectomy in 68 patients. The results are not dissimilar from many series with a perioperative mortality of less than 2% and a morbidity of 54%, which is at the upper end of most reported series. More disturbing is their pancreatic fistula rate of 33%. Fortunately, about half the patients had International Study Group for Pancreatic Fistula (ISGPF) grade A fistulas and had otherwise uneventful postoperative courses.2
Lillemoe KD. Omental Roll-up Technique Decreases Pancreatic Fistula–or Does It?Comment on “Efficacy of Omental Roll-up Technique in Pancreaticojejunostomy as a Strategy to Prevent Pancreatic Fistula After Pancreaticoduodenoectomy”. Arch Surg. 2012;147(2):150-151. doi:10.1001/archsurg.2011.1032