Role of Afferent loop decompression in preventing Clinically Relevant Post Operative Pancreatic Fistula (CR-POPF) after Pancreaticoduodenectomy.

Study title - Role of Afferent loop decompression in preventing Clinically Relevant Post Operative Pancreatic Fistula (CR-POPF) after Pancreaticoduodenectomy.

Pancreaticoduodenectomy (PD), commonly known as the Whipple procedure, is widely considered the definitive surgical treatment for tumors arising from the periampullary region. POPF remains the most impactful complication following Pancreaticoduodenectomy. CR-POPF occurs in approximately 10% to 30% of cases, with its likelihood influenced by both patient-related and intraoperative variables. Exciting strategies to reduce CR-POPF have limited effectiveness or require expensive adjuncts. Intraluminal pressure is a modifiable factor with strong physiologic link to POPF. Afferent loop decompression is a simple, reproducible and low cost intervention with limited data on effectiveness in preventing CR-POPF. Our study aims to determine incidence of  CR-POPF in patients with Afferent Loop decompression in Pancreaticoduodenectomy compared to standard technique and to determine whether ALD is an effective strategy to decrease burden of CRPOPF.