Rare, Uncommon, and Unusual Complications After Pancreaticoduodenal Resection

Thinzar M Lwin; Natasha Leigh; Mazen E Iskandar; Justin G Steele; Michael G Wayne; Avram M Cooperman

doi:10.1016/j.suc.2017.09.015

Rare, Uncommon, and Unusual Complications After Pancreaticoduodenal Resection

Surg Clin North Am. 2018 Feb;98(1):87-94. doi: 10.1016/j.suc.2017.09.015.

Authors

Thinzar M Lwin¹, Natasha Leigh², Mazen E Iskandar³, Justin G Steele⁴, Michael G Wayne⁴, Avram M Cooperman⁵

Affiliations

¹ Department of Surgery, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093, USA; Department of Surgery, Mt Sinai Beth Israel, 10 Nathan D Perlman Place, New York, NY 10003, USA.
² Department of Surgery, Mt Sinai St Luke's-West Medical Center, 1000 10th Avenue, New York, NY 10019, USA.
³ Department of Surgery, Mt Sinai Beth Israel, 10 Nathan D Perlman Place, New York, NY 10003, USA; Department of Surgery, Mt Sinai St Luke's-West Medical Center, 1000 10th Avenue, New York, NY 10019, USA.
⁴ The Pancreas, Biliary and Advanced Laparoscopy Center of New York, 305 Second Avenue, New York, NY 10003, USA.
⁵ The Pancreas, Biliary and Advanced Laparoscopy Center of New York, 305 Second Avenue, New York, NY 10003, USA. Electronic address: avram.cooperman@gmail.com.

Abstract

Complications after pancreaticoduodenal resection occur in at least 30% of patients. Most are a direct result of an intraoperative event, dissection, or anastomoses which account for the most serious morbidities, sepsis, pseudoaneurysms, and hemorrhage. Rarely, complications are due to the systemic impact of the procedure even if the procedure itself was unremarkable. Rare systemic complications after PDR (Transfusion transmitted Babesiosis, pituitary apoplexy, and TRALI) and a number of uncommon and unusual other complications are discussed. Pancreaticoduodenal resection is a significant operation with serious consequences. Decisions on selection of candidates and safe operations should be thoughtful and always in surgeons' minds.

Keywords: Pancreaticoduodenal resection; Pancreaticoduodenectomy; Pituitary apoplexy; Postpancreatectomy complications; Pseudoaneurysm; Transfusion-related lung injury; Transfusion-transmitted babesiosis; Whipple procedure.

Publication types

Review

MeSH terms

Acute Lung Injury / etiology*
Babesiosis / etiology*
Blood Transfusion
Humans
Pancreatic Neoplasms / surgery*
Pancreaticoduodenectomy / adverse effects*
Pituitary Apoplexy / etiology*
Postoperative Complications / etiology*
Rare Diseases*

Grants and funding

T32 CA121938/CA/NCI NIH HHS/United States