Surgical Outcome of Pancreaticoduodenectomy in Pancreatic and Periampullary Neoplasms.

Autor:	Shah MF; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Pirzada MT; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Nasir IUI; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Malik AA; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Farooq U; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Anwer AW; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Khattak S; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Yusuf MA; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Syed AA; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore., Hanif F; Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore.
Jazyk:	angličtina
Zdroj:	Journal of the College of Physicians and Surgeons--Pakistan : JCPSP [J Coll Physicians Surg Pak] 2017 Sep; Vol. 27 (9), pp. 559-562.
DOI:	2700
Abstrakt:	Objective: To report the results in the surgical treatment of pancreatic and periampullary neoplasms with emphasis on surgical technique, short-term postoperative outcome and the lessons learnt. Study Design: Case series. Place and Duration of Study: This study was carried out at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, from October 2014 to May 2016. Methodology: Patients undergoing surgical treatment of pancreatic and periampullary neoplasms were selected. Patients' characteristics including demographics, surgical technique, and 30-day morbidity and mortality were recorded. International Study Group of Pancreatic Fistula (ISGPF) classification was used to define postoperative pancreatic fistula and Clavien-Dindo classification to grade complications. Results: Atotal number of 65 patients underwent the trial of dissection; 50 had pancreaticoduodenectomy and 15 patients underwent palliative bypass and were excluded from analysis. Sixty-four percent were males and 36% were females. The most common tumor was periampullary (n=29, 58%) followed by pancreatic head (14, 28%) and duodenal tumors (n=07, 14%). Mean age was 52.92 ±13.27 years; mean operating time was 470 ±358.28 minutes and median blood loss was 400 (287-500) ml. Pancreaticogastrostomy (PG) was the preferred reconstruction technique in 37 (74%) verses pancreaticojejunostomy (PJ) in 13 (26%) patients. Four (08%) patients needed portal vein reconstruction and two (04%) replaced right hepatic artery resection and reconstruction due to tumor involvement. There were seven Grade A, and one Grade B and C pancreatic fistulae each. Three patients (06%) needed endoscopic therapy for gastrointestinal hemorrhage from pancreatic stump. There was one death in postoperative period. Conclusion: Pancreaticoduodenectomy is a safe procedure with excellent postoperative outcome, if carried out in a specialized hepato-pancreato-biliary unit. APG reconstruction can be a safer alternative to PJ.
Databáze:	MEDLINE
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