DOES THE PRESENCE OF CHRONIC NONSPECIFIC PANCREATITIS IN THE PATHOLOGY SPECIMEN AFFECTTHE PREVALENCE OF PANCREATIC FISTULA DEVELOPMENT FOLLOWING PANCREATICODUODENECTOMY?

*Doğan Erdoğan and Mehmet Ali Uzun

Introduction: Postoperative pancreatic fistula (POPF) is the most important complication occurring after pancreaticoduodenectomy (PD). It is essential to identify the causes of POPF development and to take preventive measures. Method: The data of 113 patients who underwent PD in our hospital with a diagnosis of periampullary tumor were reviewed retrospectively and were divided into two groups as those without chronic nonspecific pancreatitis (Group 1) and those with chronic nonspecific pancreatitis (Group 2) accompanying the tumor in the pathology specimens. The demographic data and frequency of POPF development in the two groups were compared. Results: Groups 1 and 2 comprised 42 and 71 patients, respectively. There were no significant differences between the groups in terms of age, sexdistribution, American Society of Anesthesiologists (ASA) scores, preoperative laboratory data, operation time, pancreaticojejunostomy (PJ) procedureor mortality (p>0.05). Biochemical leakage was observed in 17 patients (33.3%) in Group 1 and in seven patients (9.9%) in Group 2.There was no clinically relevant leakage (Grade B and C) observed in Group 2, whereas four patients in Group 1 (9.5%) had clinically relevant leakage. The rates of biochemical leakage and clinically relevant leakage were significantly higher in Group 2 than in Group 1 (p<0.05). Conclusion: The present study found the incidence of POPF to be significantly lower in the pathology specimens of patients with accompanying chronic nonspecific pancreatitis. The authors believe that the preoperative or intraoperative detection of nonspecific pancreatitis could be an important predictor of POPF development.