Pancreatic fistula grade C after pancreatoduodenal resection

The main complication after pancreatoduodenal resection is pancreatic fistula, which is recorded in up to 30% of cases. Pancreatic fistula significantly worsens both immediate and long-term results of patient treatment. The most dangerous is grade C fistula, in which the mortality rate reaches 20—35%. This work analyzes works devoted to the study of risk factors for the development and various methods of treatment of pancreatic fistula grade C. The main factors and predictors are identified that can help predict the development of this formidable complication and take timely therapeutic and diagnostic measures. The main surgical methods of treatment (sanitation and drainage, pancreatectomy, external and internal virsungostomy, anastomotic reshaping, occlusion of the pancreatic duct) are reviewed, and the advantages and disadvantages of each of them are analyzed. Currently, there is no consensus and algorithm for the treatment of class C PF, and therefore the study of this issue seems to be an urgent task.