{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:46:15Z","timestamp":1789728375125,"version":"4.0.1"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2005,6,1]],"date-time":"2005-06-01T00:00:00Z","timestamp":1117584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,8,17]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Optimal management of severe pancreatic leakage after pancreatoduodenectomy can reduce morbidity and mortality. Completion pancreatectomy may be adequate but leads to endocrine insufficiency. This study evaluated an alternative management strategy for pancreatic leakage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Outcome after disconnection of the jejunal limb, resection of the pancreatic body and preservation of a small pancreatic remnant, performed between 1997 and 2002, was compared with that after completion pancreatectomy performed between 1992 and 1996.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pancreatoduodenectomy was performed in 459 consecutive patients. Pancreatic leakage occurred in 41 patients (8\u00b79 per cent); its incidence did not change over the study period. Non-surgical drainage procedures were performed in 14 patients, of whom one died, and surgical drainage in eight patients, of whom two died. Completion pancreatectomy was performed in nine patients with no deaths. A pancreatic remnant was preserved in ten patients, of whom three died. A remnant tail had to be resected in two patients and three patients still developed endocrine insufficiency (\u2018brittle\u2019 diabetes).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of pancreatic leakage did not change over the study interval. Preservation of a small pancreatic tail was associated with higher morbidity and mortality rates than those of completion pancreatectomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.5047","type":"journal-article","created":{"date-parts":[[2005,6,1]],"date-time":"2005-06-01T16:17:02Z","timestamp":1117642622000},"page":"1117-1123","source":"Crossref","is-referenced-by-count":172,"title":["Incidence and management of pancreatic leakage after pancreatoduodenectomy"],"prefix":"10.1093","volume":"92","author":[{"given":"S M M","family":"de Castro","sequence":"first","affiliation":[{"name":"Department of Surgery, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O R C","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T M","family":"van Gulik","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Obertop","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D J","family":"Gouma","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2005,6,1]]},"reference":[{"key":"2021070906211074200_bib1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/00000658-199709000-00004","article-title":"Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes","volume":"226","author":"Yeo","year":"1997","journal-title":"Ann Surg"},{"key":"2021070906211074200_bib2","first-page":"1370","article-title":"Low mortality following resection for pancreatic and periampullary tumours in 1026 patients: UK survey of specialist pancreatic units. 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