The management of pancreatic fistula after pancreatic surgery.

Postoperative pancreatic fistula is a complex and dreaded complication after pancreatic surgery. Its management is complex and dependent on clinical presentation and severity and clear guidelines are often lacking. This review aims to present the current evidence-based strategies for mitigating the deleterious effects of POPF in the peri- and postoperative setting. Therapy of pancreatic fistula clearly means treatment of complications. Therefore, we discuss medical, interventional and surgical approaches for the management of POPF and its related complications. Furthermore, we discuss surgical as well as physical and chemical intra-operative techniques to prevent POPF. Evidence-based strategies are necessary to further reduce morbidity and mortality following pancreatic surgery and improve overall quality of care.