Intraabdominal hemorrhage after a pancreatectomy

Tani, Masaji; Kawai, Manabu; Yamaue, Hiroki

doi:10.1007/s00534-007-1303-9

Cited by 15 publications

(11 citation statements)

References 35 publications

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“…Despite the trend toward a decreasing rate of postoperative mortality, the morbidity rates associated with pancreatoduodenectomy are reportedly still high [, 18, 19]. Even high‐volume centers with vast experience in pancreatic surgeries have reported rates of major complications of approximately 20% for patients undergoing pancreatoduodenectomy [3].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing infectious complications after pancreatoduodenectomy

Koga

Saiura

et al. 2009

J Hepato Biliary Pancreat

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Section: Discussionmentioning

confidence: 99%

Factors influencing infectious complications after pancreatoduodenectomy

Koga

Saiura

et al. 2009

J Hepato Biliary Pancreat

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“…Efficient and accurate diagnosis is crucial. CT has been recommended by some authors [30,32,37,39]. For other authors, surgery is the first choice for the diagnosis and treatment of DPPAB [18,23,24,36].…”

Section: Discussionmentioning

confidence: 99%

“…Sentinel bleeding has been reported to precede delayed bleeding in 25–100% of cases [10,11,12,19,23,27,35]. This probably reflects local sepsis and probable anastomotic dehiscence [20,32]. Tien et al [47] recommended angiography for every sentinel bleeding after PD.…”

Section: Discussionmentioning

confidence: 99%

“…However, the cut-off point they used for DPPAB was 24 h after surgery. When referring to post-pancreatectomy bleeding, most authors claimed that bleeding at the early and late stage should be categorized as different entities [10,12,19,22,23,32,33]. Late bleeding after PD usually occurred >5–7 days postoperatively, with the time interval between the index operation and delayed bleeding ranging from 5 to 206 days [11,20,21,25,27,34,35,36,37].…”

Section: Discussionmentioning

confidence: 99%

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Management of Delayed Post-Pancreaticoduodenectomy Arterial Bleeding: Interventional Radiological Treatment First

et al. 2011

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“…However, because of advances in interventional techniques, mortality due to intra-abdominal hemorrhage has decreased. Moreover, the use of fibrin glue or polyglycolic acid felt and wrapping of the skeletonized vessels by omentum or falciform ligament reportedly decreases intra-abdominal hemorrhage [7-15]. However, intra-abdominal hemorrhage remains a frequent complication, and many surgeons are concerned by this complication.…”

Section: Introductionmentioning

confidence: 99%

Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique

Usuba¹,

Iino²,

Hanyu³

2013

J Med Case Reports

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IntroductionIntra-abdominal hemorrhage following pancreatic fistula is a fatal complication after pancreatico-duodenectomy. Intra-abdominal hemorrhage has reportedly decreased with the use of fibrin glue or polyglycolic acid felt and wrapping of the skeletonized vessels by omentum or falciform ligament. However, there are no extremely effective methods for the prevention of hemorrhage. Here, we report our novel and simple method for the prevention of intra-abdominal hemorrhage due to pancreatic fistula.MethodsThe anastomotic site of the pancreato-jejunostomy in pancreatico-duodenectomy is displaced from the superior to inferior side of the transverse mesocolon through a small window created on the left side of the middle colic artery of the transverse mesocolon. This procedure is expected to prevent exposure of the skeletonized vessels to activated pancreatic juice from a pancreatic fistula after lymph node dissection, decreasing the incidence of hemorrhage. Two drains are placed on the superior and inferior sides of the transverse mesocolon. We performed this procedure in seven patients and compared the amylase level in the drainage fluid from the superior and inferior sides.ResultsThere was no difference in the fluid amylase level from the drains between the superior and inferior sides, because a pancreatic fistula was not present in all our patients. Therefore, we could not evaluate the efficacy of this method in the current study.ConclusionsOur procedure is theoretically expected to prevent intra-abdominal hemorrhage and will be an option in pancreatico-duodenectomy, especially for patients with a soft pancreas. However, it is necessary to evaluate the performance and results of this procedure in many more patients.

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Intraabdominal hemorrhage after a pancreatectomy

Cited by 15 publications

References 35 publications

Factors influencing infectious complications after pancreatoduodenectomy

Factors influencing infectious complications after pancreatoduodenectomy

Management of Delayed Post-Pancreaticoduodenectomy Arterial Bleeding: Interventional Radiological Treatment First

Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique

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