Prevention and treatment of complications in pancreatic cancer surgery

Pancreatic cancer is the fourth leading cause of death from malignant disea se in Western industrialized countries. It is a devastating disease with a very poor prognosis and has a death rate roughly equal to its incidence rat e. As this tumor is resistant to all medical treatment options, such as rad io- and chemotherapy, radical surgical resection is the only chance of cure so far. Significant advances have been made over the past decades in pancr eaticoduodenectomy, which is the standard operation in patients with pancre atic head cancer or periampullary cancer. In specialized centers the operat ive mortality has fallen under 5%. However, the postoperative complication rates after this demanding procedure a re still between 30 and 40%. Complic ations are mainly due to the technical difficulty of performing a safe and proper anastomosis between the stomach or small bowel and the soft pancreas . This article reviews the treatment of the complications most frequently o ccurring after pancreatic cancer surgery, such as leakage of pancreatic ana stomosis, pancreatic fistula, abscess and hemorrhage. Furthermore, we discu ss the management of these complications and how complications following pa ncreatic surgery can be prevented.