Prevention and Treatment of Pancreatic Fistulae and Leaks in Carcinoma Pancreas

Postoperative pancreatic fistula (POPF) is the most dreaded complication and outcome determinant of pancreatic surgery. Fistula Risk Score remains the most widely validated and accepted system. Studies have not demonstrated superiority of one surgical technique over the other in preventing CR-POPF and mitigating pancreatic leaks, leaving it to the surgeon to adopt the best technique based on their experience. Algorithm based early recognition and management has shown to remarkably reduce the overall morbidity and mortality of pancreatic surgery. This chapter will discuss the pertinent components of prevention, mitigation and management of POPF.