Prevention and Management of Anastomotic Leaks and Fistulae

Anastomotic leaks are a surgeon’s and patient’s nightmare. It increases both morbidity and mortality. Incidence of anastomotic leak ranges from 2% to 10% amongst patients undergoing gastrointestinal surgery. When seen in cancer surgeries, it not only increases septic complications but also local recurrence and decreases overall survival. The risk of anastomotic leaks are associated with patient’s general condition and lifestyle, site of anastomosis and technique of surgery. It is managed both by surgical and non surgical methods. Post operative pancreatic fistula (POPF) is the most dreaded complication after pancreaticoduodenectomy. Although with the advancements in technology and surgical techniques both incidence and mortality related to POPF has decreased but still its management has its own set of challenges.