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Invited Critique
October 20, 2008

Pancreatogastrostomy as a Salvage Procedure to Treat Severe Postoperative Pancreatic Fistula After Pancreatoduodenectomy—Invited Critique

Arch Surg. 2008;143(10):971. doi:10.1001/archsurg.143.10.971

Postoperative pancreatic fistula remains the most troublesome complication after PD. Several methods can be used for pancreatic reconstruction after resection. Each method has its proponents and its advantages and disadvantages. Nevertheless, POPFs continue to occur.

Bachellier and colleagues are advocates of telescoped PG as their method for primary reconstruction and believe that this reduces the incidence of POPF. They report a small case series using PG for patients they thought required reexploration for severe POPF and compare these patients with another small older cohort of patients who underwent completion pancreatectomy for POPF before the authors' conversion to using PG for reconstruction.

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