Purpose

-To illustrate the normal postoperative aspects after pancreatic resection.

-To describe imaging features of postoperative complications after pancreatic resection based on a single center retrospective study and literature findings.

Material and methods

The clinical data of 42 patients who underwent pancreaticoduodenectomy or distal pancreatectomy in the surgical unit of general surgery at the hospital Sahloul (Sousse-Tunisia) between 2014 and 2019 were collected and retrospectively reviewed.

Medium- and longterm follow-up data were obtained through the same medical database. Mean age of our patients was about 56 years with a 1.8 male preponderance.

Imaging procedures included esophageal transit and 64-slice (Siemens) multidetector computed tomography wich provided a precise response to the surgeon questions without using magnetic resonance imaging.

Results

Post operative complications were found among 20 patients and include delayed gastric emptying (n=4), pancreatic fistula (n=2), post operative pancreatitis (n=1), bleeding and hemorrhage (n=1), liver abscess and postoperative peritonitis (n=3), pseudocyst of the pancreatic stump (n=2) and tumor recurrence (n=7).

Periampular tumor remains the most common indication for pancreaticoduodenectomy. It is most often an adenocarcinoma of the head of the pancreas (n=16/38%), followed by adenocarcinoma of Vater's bulb and bile ducts (n=12/28%).

Conclusion

Imaging plays an essential role in post-operative detection of complications associated with pancreatic resection and plays a key role in helping decrease the morbidity and mortality associated with surgery.We exposed common findings on imaging to familiarize the abdominal radiologists evaluating post-operative imaging in both acute and chronic post-operative settings.