| Autor: |
Joan, Figueras, Antonio, Codina-Barreras, Santiago, López-Ben, Albert, Maroto, Silvia, Torres-Bahí, Héctor Daniel, González, Maite, Albiol, Laia, Falgueras, Berta, Pardina, Jorge, Soriano, Antonio, Codina-Cazador |
| Rok vydání: |
2008 |
| Předmět: |
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| Zdroj: |
Cirugia espanola. 83(4) |
| ISSN: |
0009-739X |
| Popis: |
Pancreatoduodenectomy (PD) with initial dissection of the superior mesenteric artery (SMA) has been described as a useful technical variant to reduce blood loss and to avoid an unnecessary intervention in those cases with arterial involvement.To analyse the results of two recent technical modifications of PD introduced by our group: initial dissection of SMA and antecolic gastroenterostomy.Patients were divided into two groups: with and without initial dissection of the SMA. The results were also analysed according to the type of gastric reconstruction. Perioperative and long-term results are compared.The overall mortality was 5%, with no significant differences between the initial SMA dissection and conventional PD. The transfusion rate (p0.001), the volume of blood products transfused (p = 0.001), and the overall complication rate were lower (p = 0.01) in the initial SMA dissection group. Also the postoperative hospital stay was significantly lower (por= 0.001). Despite a higher frequency of lymph node involvement in patients treated with initial SMA dissection (p = 0.001), the recurrence rate was similar between both groups. Among patients with initial SMA dissection, those who received antecolic reconstruction had a lower rate of delayed gastric emptying (p = 0.008).Initial SMA dissection PD is a safe technique. The transfusion rate, morbidity and postoperative hospital stay are better when compared with conventional CPD. When an antecolic duodenal-jejunal reconstruction is associated, delayed gastric emptying cases are less frequent. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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