Postoperative pancreatic fistula after pancreatic cancer surgery: Past and present of ISGPS classification

Melih Can Gul

doi:10.5281/zenodo.17163030

Authors

Melih Can Gul Afyonkarahisar State Hospital Department of Gastroenterology Surgery, Afyonkarahisar, Türkiye https://orcid.org/0000-0002-6165-1144

DOI:

https://doi.org/10.5281/zenodo.17163030

Abstract

To the Editor,

Postoperative pancreatic fistula (POPF) is a frequent and consequential complication after cancer-related pancreatic resections. Even in high-volume centers, reported incidence after pancreatoduodenectomy ranges from ~5% to 30%, and distal pancreatectomy historically reaches 30–40% in some series. POPF prolongs hospitalization and drives secondary problems—abscess, sepsis, hemorrhage, and delayed gastric emptying—despite overall perioperative mortality falling below 5% in specialized units. Although Grade C events are uncommon (<5%), they carry a grave prognosis, with postoperative mortality reported up to 20–30% when organ failure or erosive bleeding occurs.

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