A five-year experience with organ-preserving resection of the pancreatic head in patients with chronic pancreatitis
| Autor: | G Farkas, L Leindler, G Farkas Jr, M Daróczi |
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| Rok vydání: | 2005 |
| Předmět: | |
| Zdroj: | Zeitschrift für Gastroenterologie. 43 |
| ISSN: | 1439-7803 0044-2771 |
| Popis: | Introduction: In chronic pancreatitis (CP), enlargement of the pancreatic head develops in consequence of inflammatory alterations. A safe procedure has been developed for organ-preserving pancreatic head resection, and this report is concerned with the results attained with this operation in a five years period. Patients: In 110 patients (m: 82, f: 28; mean age: 47.5 yr.), a new surgical management was performed. The preoperative morbidity comprised frequent abdominal pain, a weight loss in all patients, jaundice in 9 patients, and latent and insulin-dependent diabetes mellitus (IDDM) in 11 and 15 patients, respectively. The surgical procedure consists of a wide excision of the inflammatory tumour in the region of the pancreatic head, without division and cutting of the pancreas over the portal vein. Reconstruction, with drainage of the secretion from the remaining pancreas into the intestinal tract, takes place through a jejunal Roux-en-Y loop. In 9 icteric cases and in 14 patients with stenosis of the common bile duct, prepapillary bile duct anastomosis was also performed with the jejunal loop. Results: Only one reoperation was performed in consequence of anastomosis bleeding, but no mortality was noted in the postoperative period. The duration of hospitalization ranged between 7 and 12 days. In the mean follow-up period of 2.5 years (range 0.5 to 5.0), 100 patients became complaint-free, 10 patients had moderate symptoms and the weight increased with a median of 10.4kg (range 4–28). After one and two years of operation, bilio-digestive anastomosis was performed in 4 patients in consequence of bile duct stenosis. No change was noted in the preoperative endocrine function of 104 patients but 6 patients with latent diabetes mellitus became IDDM Conclusion: The five-year experience clearly reveals that this organ-preserving pancreatic head resection is a safe and effective procedure for definitive control of the complications following the inflammatory alterations of CP. |
| Databáze: | OpenAIRE |
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