Authors : Edla Vamshi Krishna; Usha Topalkatti, M. D.; Adeeb Afsar; Preethika Murugesan; Ameer M. Shazley; Vipin Narayan Sharma

Volume/Issue : Volume 10 - 2025, Issue 12 - December

Google Scholar : https://tinyurl.com/4h9t8dxc

Scribd : https://tinyurl.com/4w27pk5z

DOI : https://doi.org/10.38124/ijisrt/25dec1153

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Abstract : Pancreaticoduodenectomy (Whipple procedure) is associated with low perioperative mortality in high-volume centers; however, postoperative morbidity remains high, with postoperative pancreatic fistula (POPF) being one of the most significant complications. As defined by the International Study Group on Pancreatic Fistula, POPF is diagnosed when drain fluid collected on or after postoperative day three shows amylase levels greater than three times the upper limit of normal serum values, with clinically relevant cases (Grades B and C) often requiring therapeutic intervention and occasionally leading to severe outcomes. Despite advances in surgical and perioperative management, POPF continues to contribute to prolonged hospitalization and increased morbidity. Negative pressure systems have emerged as a potential adjunct in managing complex postoperative wounds by improving fluid evacuation and promoting tissue healing. This retrospective study evaluates the impact of negative pressure systems on the healing rates of post-surgical pancreatic fistulas and assesses their potential role in improving clinical outcomes.

References :

1. de Castro SMM, Busch ORC, van Gulik TM, Obertop H, Gouma DJ Incidence and management of pancreatic leakage after pancreatoduodenectomy. British Journal of Surgery. 2005 Sep;92(9):1117–23.
2. Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery. 2017 Mar;161(3):584–91.
3. .Oneil Machado N. Pancreatic Fistula after Pancreatectomy: Definitions, Risk Factors, Preventive Measures, and Management—Review. International Journal of Surgical Oncology. 2012;2012:1–10.
4. Lermite E, Sommacale D, Piardi T, Arnaud J-P, Sauvanet A, Dejong CHC, et al. Complications after pancreatic resection: Diagnosis, prevention and management. Clinics and Research in Hepatology and Gastroenterology. 2013 Jun;37(3):230–9.
5. Keck T, Wellner UF, Bahra M, Klein F, Sick O, Niedergethmann M, et al. Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial. Annals of Surgery. 2016 Mar;263(3):440–9.
6. Menahem B, Guittet L, Mulliri A, Alves A, Lubrano J. Pancreaticogastrostomy Is Superior to Pancreaticojejunostomy for Prevention of Pancreatic Fistula After Pancreaticoduodenectomy: An Updated Meta-analysis of Randomized Controlled Trials. Annals of Surgery. 2015 May;261(5):882–7.
7. Malleo G, Pulvirenti A, Marchegiani G, Butturini G, Salvia R, Bassi C. Diagnosis and management of postoperative pancreatic fistula. Langenbeck’s Archives of Surgery. 2014 Oct;399(7):801–10.
8. Smits FJ, van Santvoort HC, Besselink MG, Batenburg MCT, Slooff              RAE, Boerma D, et al. Management of Severe Pancreatic Fistula After Pancreatoduodenectomy. JAMA Surgery. 2017 Jun 1;152(6):540.
9. Allen PJ, Gönen M, Brennan MF, Bucknor AA, Robinson LM, Pappas MM, et al. Pasireotide for Postoperative Pancreatic Fistula. New England Journal of Medicine. 2014 May 22;370(21):2014–22.
10. Subramonia S, Pankhurst S, Rowlands BJ, Lobo DN.  Vacuum-Assisted Closure of Postoperative Abdominal Wounds: A Prospective Study. World J Surg. 2009;33(5):931–7.
11. Bruhin A, Ferreira F, Chariker M, Smith J, Runkel N. Systematic  review and evidence based recommendations for the use of Negative Pressure Wound Therapy in the open abdomen. International Journal of Surgery. 2014 Oct;12(10):1105–14.