| Autor: |
Gueroult, Sylvie, Parc, Yann, Duron, Françoise, Paye, Fran çoise, Parc, Rolland |
| Předmět: |
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| Zdroj: |
Archives of Surgery; Jan2004, Vol. 139 Issue 1, p16-19, 4p |
| Abstrakt: |
Hypothesis: Completion pancreatectomy in patients with pancreatic leakage associated with postoperative peritonitis after pancreaticoduodenectomy is a viable salvage procedure. Design: Retrospective analysis from a cohort of consecutive patients admitted between January 1, 1989, and December 31, 1999, for postoperative peritonitis originating from pancreaticojejunostomy leakage. Setting: Tertiary referral center with surgical intensive care unit specializing in the treatment of intra-abdominal sepsis. Patients: Eight consecutive patients with postoperative peritonitis originating from pancreaticojejunostomy after pancreaticoduodenectomy, with a mean Acute Physiology and Chronic Health Evaluation II score of 18.6. We excluded patients with pancreatic fistulas or abscesses amenable to percutaneous drainage or other conservative treatment. Intervention: Completion pancreatectomy. Main Outcome Measures: Mortality, morbidity, and long-term outcome, which was assessed by interview. Results: Three patients died in the postoperative period: 2 required early reoperation during the postoperative period and died of hemorrhage and sepsis, and 1 died of multiorgan failure without reoperation. Recurrence of carcinoma was responsible for late death of 2 other patients. Conclusions: Posotperative peritonitis after pancreaticoduodenectomy still has high mortality; however, completion pancreatectomy may represent the only means to achieve source control of infection in cases of postoperative peritonitis. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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