Evaluation of the role of morphological features of pancreas in postoperative pancreatic fistula formation after whipples pancreaticoduodenectomy

Introduction: Postoperative pancreatic fistula (POPF) remains the Achilles heel of Whipples pancreaticoduodenectomy. Although multiple approaches to decrease POPF rates have been reported, an effective preventive strategy has not been found. Methods: The morphological nature of pancreas in eighty-two consecutive cases of Whipples pancreaticoduodenectomy done in high volume pancreatic at Kasturba medical college, Manipal between January 2014 to July 2019 and its contribution in formation of POPF has been studied. Results: Of the cases taken in the study, 48.8% patients has a non dilated pancreatic duct and 50% patients had a soft pancreatic consistency. Both Non dilated pancreatic duct and soft pancreas were statistically significant in contributing to a biochemical leak but was not proven to be a significant risk factor in formation of POPF. Conclusion: This result is contrary to the validated notion that Pancreatic morphology tends to be the most consistent factor that affects formation of Pancreatic fistula.