How is management of complications of pancreaticoduodenectomy?

Delay Gastric Emptying time Common Tx conservative : iv Erythromycin Mostly self-limit Pancreatic Fistula / Leakage : 10% of Pt Octreotide : North American : no benefit Europe : routine use Selective used if PD <3mm. (High rate complication) Duct-to-mucosa VS Invagination Depend on size PD and Pancreatic Texure Large PD , Fibrotic Pancreas : Duct to mucosa Small PD , soft Pancreas : Invagination PD stent : Reduce incidence of Pancreatic fistula in some study