Pancreatic Fistulae after Urologic Surgery - A Single Centre Experience

Introduction: To evaluate incidence, symptoms and management of postoperative pancreatic fistula (POPF) after urologic surgery based on our experience. Material and Methods: Database was searched for clinically evident POPF after urologic surgery between 1998 and 2014. Fistulae were graded using the POPF classification. Clinical course of every POPF patient was evaluated. Results: During this time, 3,200 surgeries for renal, adrenal and retroperitoneal pathologies were performed. Twelve POPF occurred postoperatively in this series. Eight fistulae were POPF grade A, 3 POPE grade B and one POPE grade C. POPF became clinically evident after a median of 3 days (IQR 2-3). In all POPE grade A/B patients, secretion from the pancreatic fistula completely subsided under conservative therapy. In one POPE grade C patient with positive surgical margins of urothelial cancer, conservative treatment failed and the patient died due to POPE-related sepsis. Conclusions: POPE is a rare complication after urologic surgery. Conservative therapy is the first choice of treatment and will be successful in the majority of cases. Pancreatic fistula after surgery of recurrent malignancy may have a poor outcome. (C) 2015 S. Karger AG, Basel