Cephalic Duodeno-Pancreatectomy with Pancreatic-Gastric Anastomosis with Double Purse String, in Patient with Lithiasis and Tumoral Jaundice - Case Report
| Autor: | V.O Tudor, Bianca Tudor, Constantin Copotoiu, Cosmin Nicolescu, A Tudor, Claudiu Molnar, Roşca C |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
business.industry Nausea medicine.medical_treatment double purse string Anastomosis Jaundice medicine.disease Epigastric pain Surgery medicine.anatomical_structure cephalic duodeno-pancreatectomy pancreatic fistula Pancreatic fistula Pancreatectomy Vomiting pancreatico-gastric anastomosis Medicine General Pharmacology Toxicology and Pharmaceutics medicine.symptom business General Dentistry Duct (anatomy) |
| Zdroj: | Acta Medica Marisiensis, Vol 60, Iss 5, Pp 227-230 (2014) |
| ISSN: | 2247-6113 |
| Popis: | Introduction: One of the most feared complications after cephalic duodeno-pancreatectomy remains pancreatic fistula. In recent years, various methods of pancreatico-digestive reconstruction were performed in order to reduce the rate of pancreatic fistula. One of these methods is pancreatico-gastric reconstruction by using two purse string threads. Case report: We present in this article a patient with jaundice with mixed etiology: tumoral and lithiasic. Subjectively, the patient accused sclerose-skin-jaundice, right upper quadrant and epigastric pain, nausea and vomiting. Computed tomography revealed dilatation of intraand extrahepatic bile ducts, a dilated Wirsung duct and a tumor at the biliopancreatic confluence, leading to a suspicion of vaterian ampulom. Upper endoscopy revealed a tumor protruding in the descending duodenal segment. Intraoperatively a tumor suggestive of vaterian ampulom and duct stones was shown. Surgical treatment consisted of coledocolitotomy, cephalic duodeno-pancreatectomy with pancreatic-gastric anastomosis, performed by using two purse string threads. The postoperative evolution was favorable. Conclusion: Pancreatico-gastric anastomosis using two purse string threads is a simple, safe and quick procedure, avoiding the application of sutures through the pancreatic parenchyma and thus reducing the rate of pancreatic fistula. |
| Databáze: | OpenAIRE |
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