Pancreatic Ducts Obliteration With Controlled Injection of Onyx ® : A Proposal of New Onyx ® Pancreatic Ducts Obliteration Scoring System.
| Autor: | Crafa F; Oncological and General Surgery Unit, 'St. Giuseppe Moscati' Hospital of National Relevance and High Specialty, Avellino, Italy., Vanella S; Oncological and General Surgery Unit, 'St. Giuseppe Moscati' Hospital of National Relevance and High Specialty, Avellino, Italy., Noviello A; Oncological and General Surgery Unit, 'St. Giuseppe Moscati' Hospital of National Relevance and High Specialty, Avellino, Italy., Lombardi G; Department of Radiology, 'St. Giuseppe Moscati' Hospital of National Relevance and High Specialty, Avellino, Italy., Coppola Bottazzi E; Oncological and General Surgery Unit, 'St. Giuseppe Moscati' Hospital of National Relevance and High Specialty, Avellino, Italy. |
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| Jazyk: | angličtina |
| Zdroj: | Surgical innovation [Surg Innov] 2023 Apr; Vol. 30 (2), pp. 201-204. Date of Electronic Publication: 2022 Aug 10. |
| DOI: | 10.1177/15533506221120148 |
| Abstrakt: | Background: The aim of this study was confirm the efficacy and feasibility of Onyx injection for pancreatic stump management after pancreaticoduodenectomy (PD) and investigate a new Onyx ® Pancreatic Ducts Obliteration (OPDO) scoring system of pancreatic duct obliteration (PDOb) in patients with high risk of Post-Operative Pancreatic Fistula (POPF). Study Design: We enrolled ten patients undergoing PDOb with Onyx ® intraoperative controlled injection after elective PD. Results: PDOb with Onyx ® controlled injection was classified according to the OPDO scoring system in three degrees: complete 5/10 (50%), medium 2/10 (20%) and bad 3/10 (30%). Increased amylase in abdominal drainage was identified in two patients (20%) with a degree II and III, and resolved spontaneously within a week. A "clinically relevant" POPF (CR-POPF) was observed in one patient (10%) with a degree III and none in the patients with degree I and II. Discussion: We confirm that intraoperative injection of Onyx ® is a valid solution in high-risk POPF patients and our OPDO scoring system allows obtain an intraoperative classification of the degree of PDO to prevent the CR-POPOF; furthermore, it may be suggested that the viscosity of the injected product (Onyx ® ) reduce parenchymal fibrosis. |
| Databáze: | MEDLINE |
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