Pancreatico-Gastrostomy: A Modified Two-Layered Technique.
| Autor: | Boralkar AK; Surgical Oncology, Government Cancer Hospital, Aurangabad, IND., Rafe A; Surgical Oncology, Government Cancer Hospital, Aurangabad, IND., Varudkar AS; Surgical Oncology, Government Cancer Hospital, Aurangabad, IND., Vikram Singh K; Surgical Oncology, Government Cancer Hospital, Aurangabad, IND. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2022 Jun 23; Vol. 14 (6), pp. e26227. Date of Electronic Publication: 2022 Jun 23 (Print Publication: 2022). |
| DOI: | 10.7759/cureus.26227 |
| Abstrakt: | Introduction: Pancreato-duodenal resections are commonly done for periampullary carcinomas. The outcome of the procedure is decided by pancreato-enterostomy. Pancreato-jejunostomy (PJ) has been employed largely as pancreato-enterostomy. Recently, there has been a renewed interest in pancreato-gastrostomy (PG). The debate continues on the choice of reconstruction. Methods: A hundred cases of periampullary carcinoma were subjected to modified pancreatico-gastrostomy. The pancreatico-gastrectomy was evaluated by drain fluid amylase done on days 1, 3, and 5 post-operatively and clinical findings. The leaks were classified according to the International Study Group of Pancreatic Fistula (ISGPF) classification of biochemical leaks, postoperative pancreatic fistula (POPF) B and POPF C. The leaks were evaluated against pancreatic factors like duct diameter, consistency of the pancreas, the thickness of the pancreatic neck, and duct location. Observations: Eighty percent of patients had no leaks. The biochemical leak was seen in 10% of cases. POPF B and C were observed at 5% each. Mortality was 3%. The diameter of the pancreatic duct of more than 3 mm and the firm consistency of the pancreas were favourable factors in the outcome of the anastomosis. Conclusion: A modified pancreatico-gastrostomy technique appears to be technically feasible and safe. The leak rates and mortality appear to be low. We need a higher number of patients to confirm the efficacy of this modified pancreatico-enterostomy. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Boralkar et al.) |
| Databáze: | MEDLINE |
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