Evaluation of a new modification of pancreaticogastrostomy after pancreaticoduodenectomy: anastomosis of the pancreatic duct to the gastric mucosa with invagination of the pancreatic remnant end into the posterior gastric wall for patients with cancer head of pancreas and periampullary carcinoma in terms of postoperative pancreatic fistula formation.

IF 1.6 Q4 ONCOLOGY
International Journal of Surgical Oncology Pub Date : 2014-01-01 Epub Date: 2014-09-16 DOI:10.1155/2014/490386
Mohamed Mazloum Osman, Walid Abd El Maksoud
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引用次数: 0

Abstract

Background/objectives: Postoperative pancreatic fistula (POPF) remains the main problem after pancreaticoduodenectomy and determines to a large extent the final outcome. We describe a new modification of pancreaticogastrostomy which combines duct to mucosa anastomosis with suturing the pancreatic capsule to posterior gastric wall and then invaginating the pancreatic remnant into the posterior gastric wall. This study was designed to assess the results of this new modification of pancreaticogastrostomy.

Methods: The newly modified pancreaticogastrostomy was applied to 37 consecutive patients after pancreaticoduodenectomy for periampullary cancer (64.86%) or cancer head of the pancreas (35.14%). Eighteen patients (48.65%) had a soft pancreatic remnant, 13 patients (35.14%) had firm pancreatic remnant, and 6 patients (16.22%) had intermediate texture of pancreatic remnant. Rate of mortality, early postoperative complications, and hospital stay were also reported.

Results: Operative mortality was zero and morbidity was 29.73%. Only three patients (8.11%) developed pancreatic leaks; they were treated conservatively. Eight patients (16.1%) had delayed gastric emptying, one patient (2.70%) had minor hemorrhage, one patient (2.70%) had biliary leak, and four patients (10.81%) had superficial wound infection.

Conclusions: The new modified pancreatogastrostomy seems safe and reliable with low rate of POPF. However, further prospective controlled trials are essential to support these results.

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胰十二指肠切除术后胰胃吻合术的新改良:胰管与胃粘膜吻合,胰残端内陷胃后壁,胰头癌及壶腹周围癌患者术后胰瘘形成评价
背景/目的:术后胰瘘(POPF)仍然是胰十二指肠切除术后的主要问题,并在很大程度上决定了最终的预后。我们描述了一种新的胰胃吻合术,将胰囊缝合于胃后壁,然后将胰残体内陷于胃后壁。本研究旨在评估这种新改良胰胃造口术的结果。方法:对37例连续行胰十二指肠切除术的壶腹周围癌(64.86%)或胰头癌(35.14%)患者应用新改良胰胃造口术。软质胰腺残余18例(48.65%),硬质胰腺残余13例(35.14%),中等质地胰腺残余6例(16.22%)。报告了死亡率、术后早期并发症和住院时间。结果:手术死亡率为零,发病率为29.73%。仅有3例(8.11%)发生胰腺渗漏;他们接受了保守治疗。胃排空延迟8例(16.1%),轻度出血1例(2.70%),胆漏1例(2.70%),创面浅表感染4例(10.81%)。结论:新型改良胰胃吻合术安全可靠,POPF发生率低。然而,进一步的前瞻性对照试验是支持这些结果的必要条件。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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