Postoperative pancreatic fistula is higher in patients with necrotizing pancreatitis who develop a colon-transverse fistula.

Langenbecks Arch Surg

Research Institute of General Surgery, Jinling Hospital, Nanjing Medical University, Zhongshan Road NO.E.305, Nanjing, Jiangsu, China.

Published: March 2025

Background: This study explores the association between the need for open necrosectomy (ON) during infected necrotizing pancreatitis (INP) treatment and the development of postoperative pancreatic fistula (POPF) following definitive surgery (DS) for transverse colonic fistulas.

Materials And Methods: This study was conducted at two tertiary hospitals and included patients who underwent DS for colonic fistula secondary to INP from January 2009 to December 2023. Patients were followed until hospital discharge. The primary outcome was the incidence of POPF.

Results: A total of 135 patients were included. The median age was 38 years (interquartile range [IQR]: 32-44 years), with 85 (62.9%) being male. ON was required in 52 patients (38.5%), with 24 patients developing POPF post-DS. The need for ON (odds ratio [OR] = 2.78, 95% confidence interval [CI]: 1.03-7.58, p = 0.040) and the interval from INP resolution to DS (OR = 0.82, 95% CI: 0.68-0.92, p = 0.011) were associated with POPF.

Conclusion: The need for ON during INP treatment is significantly associated with an increased risk of POPF following DS for transverse colonic fistulas.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882662PMC
http://dx.doi.org/10.1007/s00423-024-03578-4DOI Listing

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