Pancreaticojejuno Anastomosis after Pancreaticoduodenectomy: Brief Pathophysiological Considerations for a Rational Surgical Choice
| Autor: | Piero Chirletti, Giuseppe Dinatale, Roberto Caronna, Nadia Peparini, Gabriele Cosimo Russillo, Adolfo Antonio Rogano |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Percutaneous Article Subject business.industry medicine.medical_treatment Fistula Invagination Anastomosis lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Pancreaticoduodenectomy medicine.disease lcsh:RC254-282 Pathophysiology Surgery Oncology Pancreatic fistula Clinical Study medicine business Complication |
| Zdroj: | International Journal of Surgical Oncology, Vol 2012 (2012) International Journal of Surgical Oncology |
| ISSN: | 2090-1410 2090-1402 |
| DOI: | 10.1155/2012/636824 |
| Popis: | Introduction. The best pancreatic anastomosis technique after pancreaticoduodenectomy (PD) is still debated. Pancreatic fistula (PF) is the most important complication but is also related to postoperative bleedings and pancreatic remnant involution. We support pancreaticojejuno anastomosis (PJ) advantages describing our technique with brief technical considerations.Materials and Methods. 89 consecutive patients underwent PD with suprapyloric gastric resection and double loop reconstruction. Pancreaticojejunal end-to-end anastomosis was done by simple invagination with a single layer of interrupted pledget-supported Ticron stitches.Results. Pancreatic fistula occurred in seven patients (7.8%): six cases of grade A fistula resolved spontaneously, and in only one case of grade B fistula percutaneous drainage was necessary. Postoperative hemorrhage occurred in only two (2.2%) of 89 patients.Conclusion. Pancreaticojejunostomy with minor changes in anastomotic techniques can contribute to improvement of the outcome of Roux-en-Y reconstruction regarding PF and other related complications. The particular reconstruction reported seems also to preserve the pancreatic exocrine function. |
| Databáze: | OpenAIRE |
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