Robotic Redo Pancreaticojejunostomy for Stenosis Following Pancreaticoduodenectomy: An Alternative Technique

Machado, Marcel Autran; Makdissi, Fábio F.; Machado, Marcel Cerqueira César; Ardengh, José Celso

doi:10.1590/s0004-2803.202000000-35

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“…Likewise, in many reports, surgical redo-PJ appears to be safe and feasible by professional pancreatic surgeons. Reported intraoperative blood loss was less than 200 mL, and none of the patients suffered from POPF after surgery [5,11] In line with previous reports, the operation time, blood loss, and postoperative complications in our study confirmed that redo-PJ is a relatively straightforward and safe procedure when performed by professional pancreatic surgeons [4,13,22,27]. More importantly, surgical revision has a better long-term outcome when compared to endoscopic treatment.…”

Section: Table 1 Patient Demographics Index Operation Data and Pathol...supporting

confidence: 88%

“…Unfortunately, important diagnostic criteria, such as accurate measurement of MPD dilation and assessment of exocrine function of the pancreas, were not taken into consideration in various published reports. Several management modalities have been described for the treatment of PJS, including percutaneous puncture-guided CT, endoscopy, surgery, and laser dissection [2,4,12,27]. Nevertheless, there is no broad consensus regarding the therapeutic strategies for PJS.…”

Section: Table 1 Patient Demographics Index Operation Data and Pathol...mentioning

confidence: 99%

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Surgical revision for pancreatojejunostomy stricture: a case series of 14 patients

et al. 2022

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Background Pancreatojejunostomy stricture (PJS) is a rare long-term complication of pancreaticojejunal anastomosis. This study aimed to investigate the role of surgery in the management of pancreatojejunostomy strictures. Methods The database of the Pancreas Center of Nanjing Medical University was retrospectively screened for patients who underwent a surgical revision for PJS between June 2012 and August 2019, and their clinical characteristics and management modalities were reviewed. Results Fourteen consecutive cases were retrieved, the median age at index operation was 41.1 years (19–71). The average time between the two operations was 70.6 months (8–270 months). Index procedures included pancreaticoduodenectomy (PD) (7/14, 50%), pylorus-preserving PD (4/14, 28.6%), Berger procedure (2/14, 14.3%), and middle pancreatectomy (1/14, 7.1%). The diameter of the main pancreatic duct was < 4 mm in all 14 cases, and nine underwent pancreaticojejunostomy (PJ) stenting during the index operation. The most frequent complaints were abdominal pain (6/14, 42.9%), recurrent acute pancreatitis (6/14, 42.9%), pancreatic fistula (1/14, 7.1%), and abdominal distention (1/14, 7.1%). The diagnosis of PJ stricture was confirmed by computed tomography or magnetic resonance imaging in all cases. All patients had a main duct diameter > 5 mm before surgical revision. All patients underwent wedge excision with interrupted one-layer suturing with absorbable sutures and without stent placement. In this series, only one patient required reoperation. Upon follow-up, 11 of 12 patients had complete resolution of the PJ stricture. Conclusion PJS is a long-term complication of pancreatojejunostomy. Surgical revision of the anastomosis is a safe and effective treatment modality.

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Section: Table 1 Patient Demographics Index Operation Data and Pathol...supporting

confidence: 88%

Section: Table 1 Patient Demographics Index Operation Data and Pathol...mentioning

confidence: 99%

Surgical revision for pancreatojejunostomy stricture: a case series of 14 patients

et al. 2022

View full text Add to dashboard Cite

show abstract

Robotic Redo Pancreaticojejunostomy for Stenosis Following Pancreaticoduodenectomy: An Alternative Technique

Cited by 1 publication

References 3 publications

Surgical revision for pancreatojejunostomy stricture: a case series of 14 patients

Surgical revision for pancreatojejunostomy stricture: a case series of 14 patients

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