[Reconstruction following proximal pancreatoduodenectomy by simplified pancreatojejunal anastomosis. Operation results in 198 patients].

Autor:	Celis Zapata J; Departamento del Abdomen, INEN, Lima, Peru., Berrospi Espinoza F, Ruíz Figueroa E, Payet Meza E, Chávez Passiuri I, Young Tabusso F
Jazyk:	Spanish; Castilian
Zdroj:	Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru [Rev Gastroenterol Peru] 2006 Jul-Sep; Vol. 26 (3), pp. 271-7.
Abstrakt:	Introduction: The pancreatojejunal anastomosis is considered the weak spot when carrying out a duodenopancreatectomy, because it causes most of the complications following a Whipple surgery. Here we present a series of cases using a single technique for performing this anastomosis. Material and Methods: During the period between October 2002 and August 2005, 49 duodenopancreatectomies were performed at the 3AII Department of the National Hospital Edgardo Rebagliati Martins (H.N.E.R.M.) in 31 of these cases a lateral mucosa to mucosa pancreatojejunal anastomosis was carried out by the same surgeon. Results: The most frequent complication was infection of the operating wound followed by pancreatic fistula and intra-abdominal hemorrhage and the overall morbidity was 29%. Pancreatic fistula developed in 13% of the cases; however, no patient required additional treatment and the fistula closed maximum twenty days after the surgery. On average, patients resumed oral food intake after 6 days and remained hospitalized for 16 days. Mortality was 3%, because a patient developed a pseudo-aneurysm of the hepatic artery, which ruptured 17 days after the operation. Conclusions: The mucosa to mucosa pancreatojejunal anastomosis is a safe technique with a low index of pancreatic fistula and mortality.
Databáze:	MEDLINE
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