Risk factors and treatment of pancreatic fistula after pancreaticoduodenectomy        ZHANG Tai-ping，XIONG Guang-bing，DU Yong-xing，et al. Department of General Surgery，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences，Beijing 100730，China
Corresponding author：ZHAO Yu-pei，E-mail：zhao8028@263.net

Abstract    Postoperative pancreatic fistula (POPF) is the most common complication after pancreaticoduodenectomy，which has significant impacts on curative effects and prognosis. Understanding the risk factors of POPF could contribute to the prevention and treatment of the complication. The contemporary surgical literature suggests the definite risk factors for POPF development are pancreatic texture, pancreatic duct diameter, pathologic type and surgeon experience. Although anastomostic methods of digestive tract reconstruction are regarded as the risk factors for POPF, the current evidences show no significant difference in POPF incidence irrespective of the methods of pancreatic anastomosis following pancreaticoduodenectomy. Reconstructive techniques and surgeon experience have been considered as statistically significant risk factors for POPF approved by the majority of researches. Therefore, the anastomosis quality is more important than the reconstruction type. The efficacious way to reduce the incidence of POPF is selecting the suitable and skilled technique for pancreatic anastomosis.