[Impaired healing of pancreatic anastomoses]

Impaired healing of anastomoses of the pancreas are a specific and very serious complication of surgery of the pancreas. Based on experience with healing in 88 patients with anastomoses of the pancreas during the last 5 years (77 partial duodenopancreatectomies (DPE) and 11 limited resections or drainage operations) it was found that the decisive factor for complications in the area of anastomoses is soft tissue of the unaltered pancreas at the site of resection. Impaired healing was recorded in 9 cases (10%), in three of them it was however the cause of complications which proved fatal (33%). In treatment effective drainage of the peripancreatic area is most important as well as reduced pancreatic secretion due to octreotide administration. Surgical solution is called for only in the most serious cases of an insufficient anastomosis, the lethality is however, regardless of the tactics of surgical treatment, high.