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Fluid collection after distal pancreatectomy: a frequent finding

Background - Fluid collections (FC) at the resection margin of the pancreatic stump after distal pancreatectomy (DP) are common radiological findings in follow-up scans. No recommendations exist regarding the management of such findings. The aim was to characterise incidence, risk factors, clinical...

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Main Authors: Tjaden, Christin (Author) , Hinz, Ulf (Author) , Hassenpflug, Matthias (Author) , Fritz, Franziska (Author) , Fritz, Stefan (Author) , Grenacher, Lars (Author) , Büchler, Markus W. (Author) , Hackert, Thilo (Author)
Format: Article (Journal)
Language:English
Published: [2016]
In: HPB
Year: 2016, Volume: 18, Issue: 1, Pages: 35-40
ISSN:1477-2574
DOI:10.1016/j.hpb.2015.10.006
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.hpb.2015.10.006
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S1365182X15000076
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Author Notes:Christin Tjaden, Ulf Hinz, Matthias Hassenpflug, Franziska Fritz, Stefan Fritz, Lars Grenacher, Markus W. Büchler & Thilo Hackert

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520 |a Background - Fluid collections (FC) at the resection margin of the pancreatic stump after distal pancreatectomy (DP) are common radiological findings in follow-up scans. No recommendations exist regarding the management of such findings. The aim was to characterise incidence, risk factors, clinical impact and therapy of FC. - Method - Data of 209 patients who underwent DP between 07/2009 and 06/2011 were prospectively collected and analysed, regarding follow-up CT or MRI scan findings of FC at the resection margin. FC was defined as a cyst-like lesion >1 cm in diameter. - Results - A follow-up with at least two cross-sectional images was available in 159/209 patients. In the first postoperative control, 68 patients showed an FC (43%). FC size was classified as <5 cm (n = 38 pat.), 5-10 cm (n = 24 pat.) and >10 cm (n = 6 pat.). 20 patients (30%) showed clinical symptoms. Six patients (9%) required specific treatment, all other FC showed spontaneous regression. No correlation with stump closure techniques or preceding postoperative pancreatic fistula was found (4/68 patients, 6%). Multivariate analysis revealed standard resections as the only significant factor for FC. - Conclusions - FCs at the resection margin after DP are frequent and harmless findings. Therapeutic interventions are required in only 9% of all FC patients. 
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