Enveloped double purse-string versus conventional pancreatico-gastrostomy during Whipple procedure: comparative study at Sohag university onco-surgery program

El‐Badry, Ashraf Mohammad; Redwan, Alaa A.; Abusedera, Mohammad A.; Ali, H.M.

doi:10.18203/2349-2902.isj20164052

Cited by 1 publication

(1 citation statement)

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“…27,28 Central pancreatectomy with pancreatico-gastrostomy using enveloped double purse-string technique was carried out only in one case with grade III injury limited to the neck region to preserve the remaining volume of the healthy pancreatic body and tail. 29 One patient suffered from grade IV pancreatic injury that seriously affected the duodenum, with concomitant injuries in the chest and extremities. Given the difficulty of this situation, damage-control surgery by hemostasis and drainage was applied as alternative of pancreaticoduodenectomy.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of traumatic pancreatic injuries and their consequences.

El‐Badry

Ali

2020

Int Surg J

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Background: Management of pancreatic trauma remains challenging due to difficulty in diagnosis and complexity of surgical interventions. In Egypt, reports on pancreatic trauma are scarce.Methods: Medical records of adult patients with pancreatic trauma who were admitted at Sohag University Hospital (2012-2019) were retrospectively studied. Patients were categorized into group A of non-operative management (NOM), group B which required upfront exploratory laparotomy due to hemodynamic instability and group C in which surgical management was implemented after thorough preoperative assessment. Pancreatic injuries were ranked by the pancreas injury scale (PIS).Results: Thirty-two patients (25 males and 7 females) were enrolled, and median age of 36 (range: 23-68) years. Twenty-eight patients (87.5%) had blunt trauma whereas penetrating injury occurred in 4 (12.5%). There were 9 patients in group A, 7 in group B and 16 in group C. High grades of pancreatic injury ≥3 occurred in 4 patients from group B and 5 from group C. Distal pancreatectomy was performed in 7 patients while central resection and panceatico-gastrostomy in one. Grade IV injury occurred only in one patient who received damage-control laparotomy. Post-operative complication were significantly increased in group B compared with C, in correlation worse hemodynamic status and increased severity of PIS. Post-operative mortality occurred in 2 patients (6%), both from group B. Late consequences included pancreatic pseudocyst (4 cases) and walled off pancreatic necrosis (2 cases).Conclusions: High grades of pancreatic injury and hemodynamic instability correlate with worse outcome after surgery for pancreatic trauma.

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Section: Discussionmentioning

confidence: 99%