Actualidad en fístula pancreática postoperatoria

Miguel Emilio García-Rodríguez, Ramón Estopiñán-Cánovas, Héctor Céspedes-Rodríguez

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Resumen

Fundamento: el cáncer de páncreas presenta una alta mortalidad, producto que la mayoría de las veces se diagnóstica en etapa avanzada. El tratamiento de elección es la resección quirúrgica, la cual debida a su complejidad está acompañada de una morbimortalidad importante, cuando no se realiza en centros de alto volumen. Dentro de las complicaciones, la fístula pancreática postoperatoria, es de aparición frecuente.
Objetivo: realizar una revisión sistemática actualizada acerca del concepto y clasificación de la fístula pancreática postoperatoria.
Métodos: se realizó una revisión sistemática de la literatura con la base de datos SCOPUS bajo los criterios que establecen sus revisores, se utillizaron las siguientes palabras claves: pancreatic fistula, pancreatic surgery, complications, mortality, Whipple procedure. Se incluyeron todas las publicaciones en inglés y español. El método de análisis y síntesis se utilizó para la interpretación de la bibliografía.
Desarrollo: se revisaron 175 artículos, de los cuales, se escogieron 55, que cumplían con los criterios de selección. Entre ellos, cuatro metanálisis, ocho artículos de revisión y 33 artículos originales.
Conclusiones: el concepto y clasificación de la fístula pancreática postoperatoria constituye una herramienta válida para la comparación de resultados quirúrgicos entre instituciones. La centralización de la atención en centros de alto volumen constituye la principal medida para disminuir esta complicación.

DeCS: FÍSTULA PANCREÁTICA/cirugía; COMPLICACIONES POSOPERATORIAS; NEOPLASIAS PANCREÁTICAS/diagnóstico; NEOPLASIAS PANCREÁTICAS/mortalidad; MÁRGENES DE ESCISIÓN.

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