Endoscopic management of pancreatic fistula after distal pancreatectomy and enucleation

Goasguen, N.; Bourrier, Anne; Ponsot, Philippe; Bastien, Laurence; Lesurtel, Mickaël; Prat, Frédéric; Dousset, B.; Sauvanet, Alain

doi:10.1016/j.amjsurg.2008.03.005

Cited by 40 publications

(14 citation statements)

References 32 publications

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“…Normal underlying pancreatic texture partly contributes to more frequent PF occurrence. In addition, common risk factors identified for EU associated with PF in other literature included: soft texture of remnant pancreas, MPD diameter less than 3 mm, distance between tumor and MPD, body mass index, New York Heart Association (NYHA) class II or III, operation time ≥180 min, certain inherited genetic diseases, and deep EU (Goasguen et al, 2009;Brient et al, 2012;Inchauste et al, 2012;Zhang et al, 2013;Heeger et al, 2014;Atema et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Enucleation of non-invasive tumors in the proximal pancreas: indications and outcomes compared with standard resections

Cai

et al. 2017

J. Zhejiang Univ. Sci. B

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Abstract:Objective: The aim of this study was to evaluate the safety and efficiency of enucleation (EU) for proximal pancreatic non-invasive neoplasms. Methods: Patients with solitary non-invasive neoplasms in the proximal pancreas from January 1998 to April 2014 at the Second Affiliated Hospital of Zhejiang University, Hangzhou, China were included. Different operations and outcomes were analyzed. Results: A total of 123 patients were enrolled. Forty patients (32.5%) underwent EU including 18 patients who had tumors close to the main pancreatic duct (MPD). Sixty-one patients (49.6%) had pancreaticoduodenectomy (PD) performed and 22 (17.9%) underwent central pancreatectomy (CP). Pathological outcomes included neuroendocrine tumors, cystic lesions, and solid pseudopapillary tumors. Operation time, intra-operative blood loss, and duration of hospital stay were significantly reduced in the EU group. PD was associated with the greatest complication rate (55.7%), followed by EU (50%) and CP (40.9%), though the pancreatic fistula rate after EU was the highest (50%), especially in patients with tumors larger than 3 cm and tumors close to the MPD. EU had advantages in the preservation of pancreatic parenchyma and endocrine and exocrine function. Conclusions: EU can be carried out safely and effectively for tumors in the proximal pancreas with improved outcomes compared with standard resections, even if the tumor is larger than 3 cm and close to the MPD.

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Section: Discussionmentioning

confidence: 99%

Enucleation of non-invasive tumors in the proximal pancreas: indications and outcomes compared with standard resections

Cai

et al. 2017

J. Zhejiang Univ. Sci. B

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“…61,62 This technique is highly feasible and is usually well tolerated by patients. 63 Recent randomized controlled trials showed that prophylactic pancreatic stenting does not reduce postoperative pancreatic fistula after DP. 64 In fact, it increases bacterial seeding in the stent, leading to formation of abscesses.…”

Section: Perioperative Endoscopic Interventionmentioning

confidence: 99%

Minimally Invasive Distal Pancreatectomy: Review of the English Literature

Wang

Fan

2017

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…It was found to be effective in healing postoperative chylous fistulas and broncho-cutaeneous fistulas. Studies have evaluated its ability to heal malignant pleural effusions and suggest the ability of tetracycline to interfere in mesothelial cell repair, induce fibroblast enhancing growth factor secretion and inhibit metalloprotinases as contributory factors [19,20].…”

Section: Discussionmentioning

confidence: 99%

Outcome of A Non Healing Pancreatico-Cutaneous Fistula, Treated with Local Tetracycline Instillation – A Case Report

Nr¹,

Sk²,

Bk³

et al. 2016

Med Case Rep

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Endoscopic management of pancreatic fistula after distal pancreatectomy and enucleation

Cited by 40 publications

References 32 publications

Enucleation of non-invasive tumors in the proximal pancreas: indications and outcomes compared with standard resections

Enucleation of non-invasive tumors in the proximal pancreas: indications and outcomes compared with standard resections

Minimally Invasive Distal Pancreatectomy: Review of the English Literature

Outcome of A Non Healing Pancreatico-Cutaneous Fistula, Treated with Local Tetracycline Instillation – A Case Report

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