Complications after pancreaticoduodenectomy: intraabdominal abscess

The development of intraabdominal abscess (IAA) following pancreaticoduodenectomy (PD) is an important problem. It is a common cause of readmission to the hospital following discharge. Rates of IAA do not appear to depend on whether the pancreas is anastomosed to the stomach or jejunum, nor whether a duct-to-mucosa or invagination technique is used. Most surgeons favor the use of closed-suction drains after PD. The use of fibrin glue sealant does not appear to reduce the rate of IAA. The use of preoperative biliary stenting increases wound infection rates, but not IAA rates. The use of internal and external pancreatic duct stents with PD to prevent IAA have yielded mixed results.