Incidence and management of pancreatic leaks after splenectomy with distal pancreatectomy performed during primary cytoreductive surgery for advanced XXXX .

@entity1 @entity43 @entity788 @entity1697 @entity491
OBJECTIVE: To determine the incidence, management, and outcome of @entity1 diagnosed with a @entity788 after a distal pancreatectomy during primary surgical cytoreduction for @entity43 . METHODS: We performed a retrospective chart review of all @entity1 who had a distal pancreatectomy at the time of primary surgery. Charts were reviewed to identify those @entity1 who developed a persistent left upper quadrant abdominal fluid collection with elevated amylase levels. RESULTS: A total of 17 @entity1 had a distal pancreatectomy; of these, 4 @entity1 (24%) developed a postoperative @entity788 . In these @entity1 , persistent @entity491 prompted evaluation with a computed tomography scan, which subsequently revealed a fluid collection. The median time from surgery to drainage of this collection was 9 days (range, 8-66). The drain remained in situ for a median of 29 days (range, 22-82). The median amylase level of the fluid was 22,945 U/L (range, 763-47,250). The median length of hospital stay for those @entity1 with a leak was 33 days (range, 25-44), which was longer than those without a leak. However, the median time from surgery to treatment with systemic chemotherapy was 31 days (range, 16-43), which was equivalent to those without a @entity788 . CONCLUSION: Twenty-four percent of @entity1 who had undergone a distal pancreatectomy developed a @entity788 . This complication, which usually presents early in the postoperative period, can be managed conservatively with percutaneous drainage. @entity1697 may be resumed, and total parenteral nutrition is not needed in the majority of cases. Systemic chemotherapy can be administered without significant delay.
