Radiological Assessment After Pancreaticoduodenectomy for a Precision Approach to Managing Complications: A Narrative Review

Radiological assessment following pancreaticoduodenectomy is critical for the prompt diagnosis and management of postoperative complications, significantly influencing patient outcomes. Pancreaticoduodenectomy, or the Whipple procedure, is the standard surgical intervention for pancreatic and periampullary malignancies, but it involves notable risks, especially from complications like fistulas, bleeding, or leakage. Cross-sectional imaging, particularly contrast-enhanced computed tomography, serves as the primary diagnostic tool due to its rapid acquisition, high resolution, and effective delineation of postoperative anatomy and complications. Magnetic resonance imaging (with cholangiopancreatography and hepatobiliary contrast agents) complements CT by providing superior contrast resolution for specific complications, notably in the biliary system and pancreatic duct. This narrative review discusses various imaging techniques and their applications, highlighting characteristic radiological features of common postoperative complications. It underscores the importance of a multidisciplinary approach, emphasizing close collaboration between radiologists and surgeons to optimize surgical decision-making and improve patient management post-pancreatic surgery.