Abdominal Radiology

, Volume 43, Issue 2, pp 476–488 | Cite as

Imaging of post-operative pancreas and complications after pancreatic adenocarcinoma resection

  • Nima Hafezi-Nejad
  • Elliot K. Fishman
  • Atif ZaheerEmail author


Pancreatic ductal adenocarcinoma is one of the leading causes of cancer-related deaths. With surgical resection being the only definitive treatment, improvements in technique has led to an increase in number of candidates undergoing resection by inclusion of borderline resectable disease patients to the clearly resectable group. Post-operative complications associated with pancreaticoduodenectomy and distal pancreatectomy include delayed gastric emptying, anastomotic failures, fistula formation, strictures, abscess, infarction, etc. The utility of dual-phase CT with multiplanar reconstruction and 3D rendering is increasingly recognized as a tool for the assessment of complications associated with vascular resection and reconstruction such as hemorrhage, pseudoaneurysm, vascular thrombosis, and ischemia. Prompt recognition of the complications and distinction from benign post-operative findings such as hepatic steatosis and mesenteric fat necrosis on imaging plays a key role in helping decrease the morbidity and mortality associated with surgery. We discuss, with case examples, some of such common and uncommon findings on imaging to familiarize the abdominal radiologists evaluating post-operative imaging in both acute and chronic post-operative settings.


Pancreatic ductal adenocarcinoma Post-operative complications Pancreaticoduodenectomy Pancreatectomy Diagnostic imaging Computed tomography 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no relevant conflict of interest.


No funding was received for this study.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

All procedures and imaging examinations presented in this review were part of patients’ standard clinical work-up. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Nima Hafezi-Nejad
    • 1
  • Elliot K. Fishman
    • 1
  • Atif Zaheer
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of RadiologyJohns Hopkins Medical InstitutionsBaltimoreUSA
  2. 2.Pancreatitis CenterJohns Hopkins Medical InstitutionsBaltimoreUSA
  3. 3.The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins UniversityBaltimoreUSA

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