Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2024; 12(9): 1649-1659
Published online Mar 26, 2024. doi: 10.12998/wjcc.v12.i9.1649
Gradient inflammation in the pancreatic stump after pancreaticoduodenectomy: Two case reports and review of literature
Tie-Gong Wang, Liang Tian, Xiao-Ling Zhang, Lei Zhang, Xiu-Lei Zhao, De-Shuai Kong
Tie-Gong Wang, Lei Zhang, Xiu-Lei Zhao, De-Shuai Kong, Department of Surgery, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
Liang Tian, Xiao-Ling Zhang, Department of Pathology, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
Author contributions: Wang TG conceived the study and wrote the manuscript; Tian L and Zhang XL performed research (pathological analyses); Zhang L analyzed data; Zhao XL and Kong DS contributed to the new methods; and all the authors have read and agreed to the published version of the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tie-Gong Wang, MD, PhD, Attending Doctor, Department of Surgery, Cangzhou Central Hospital, No. 16 Xinhuaxi, Cangzhou 061000, Hebei Province, China. healthbycliff@gmail.com
Received: October 29, 2023
Peer-review started: October 29, 2023
First decision: December 15, 2023
Revised: December 26, 2023
Accepted: March 7, 2024
Article in press: March 7, 2024
Published online: March 26, 2024
Processing time: 147 Days and 16.4 Hours
Core Tip

Core Tip: Postoperative pancreatic fistula (POPF) is a major complication of pancreaticoduodenectomy. However, the underlying mechanisms remain unclear. Compared to the relatively simple histological structure of the gastrointestinal wall, pancreatic stump is undoubtedly the crucial factor in the occurrence of POPF. This study systemically investigated the pathology in pancreatic stumps and provided insights into the underlying mechanisms of POPF. Gradient inflammation and digestive reflux are present in the pancreatic stumps. As the understanding of the role of inflammation in POPF increases, effectively managing the side effects of inflammation will bring about a significant possibility of terminating POPF.