Pancreatoduodenectomy: Brazilian Practice Patterns

Torres, Orlando Jorge Martins; Fernandes, Eduardo de Souza Martins; Vasques, Rodrigo Rodrigues; Waechter, Fábio Luiz; Amaral, Paulo Cezar Galvão do; Rezende, Marcelo Bruno de; Costa, R. Montenegro; Montagnini, André L.

doi:10.1590/0102-6720201700030007

Cited by 10 publications

(9 citation statements)

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“…Complete surgical resection is the treatment of choice, and the approach is dependent on the location of disease. For patients with tumor located in the head of the pancreas, pancreatoduodenectomy is associated with an overall good prognosis, although recurrence can occur 13 , 15 , 21 .…”

Section: Introductionmentioning

confidence: 99%

Pancreatoduodenectomy for Solid Pseudopapillary Tumor of the Pancreas: A Multi-Institution Study

Torres

Rezende

Waechter

et al. 2019

ABCD, arq. bras. cir. dig.

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Background: Solid pseudopapillary tumor of the pancreas is a rare low-grade malignant neoplasm. Most patients present with nonspecific symptoms until the tumor becomes large. Complete surgical resection by pancreatoduodenectomy is the treatment of choice for tumors located in the head of the pancreas Aim: To analyzed the clinicopathologic features, management, and outcomes of patients who had solid pseudopapillary tumor of the head pancreas and underwent surgical resection. Methods: Were analyzed 16 patients who underwent pancreatoduodenectomy for this condition. Results: Mean age was 25.7 years old, and 15 patients were female (93.7%). Nonspecific abdominal pain was present in 14 (87.5%). All underwent computed tomography and/or magnetic resonance imaging as part of diagnostic workup. The median diameter of the tumor was 6.28 cm, and surgical resection was performed with open or laparoscopic pancreatoduodenectomy without neoadjuvant chemotherapy. Postoperative complications occurred in six patients (37.5%) and included pancreatic fistula without mortality. The mean of hospital stay was 10.3 days. Median follow-up was 3.6 years, and no patient had local recurrence or metastatic disease. Conclusion: For these patients surgical resection with pancreatoduodenectomy is the treatment of choice showing low morbidity, no mortality, and good long-term survival.

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Section: Introductionmentioning

confidence: 99%

Pancreatoduodenectomy for Solid Pseudopapillary Tumor of the Pancreas: A Multi-Institution Study

Torres

Rezende

Waechter

et al. 2019

ABCD, arq. bras. cir. dig.

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“…To prevent pancreatic fistula, various technical procedures have been described, including invagination technique, duct-to-mucosa, Blumgart technique, Peng technique, and modifications. The desirable one should be associated with a low rate of pancreatic fistula and ease to perform regardless of the texture of the pancreas and the duct diameter 1 , 6 , 9 , 13 , 14 . …”

Section: Introductionmentioning

confidence: 99%

Modified Heidelberg Technique for Pancreatic Anastomosis

Torres

Costa

et al. 2017

ABCD, arq. bras. cir. dig.

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Background : Pancreatic fistula is a major cause of morbidity and mortality after pancreatoduodenectomy. To prevent this complication, many technical procedures have been described. Aim: To present a novel technique based on slight modifications of the original Heidelberg technique, as new pancreatojejunostomy technique for reconstruction of pancreatic stump after pancreatoduodenectomy and present initial results. Method: The technique was used for patients with soft or hard pancreas and with duct size smaller or larger than 3 mm. The stitches are performed with 5-0 double needle prolene at the 2 o’clock, 4 o’clock, 6 o’clock, 8 o’clock, 10 o’clock, and 12 o’clock, positions, full thickness of the parenchyma. A running suture is performed with 4-0 single needle prolene on the posterior and anterior aspect the pancreatic parenchyma with the jejunal seromuscular layer. A plastic stent, 20 cm long, is inserted into the pancreatic duct and extended into the jejunal lumen. Two previously placed hemostatic sutures on the superior and inferior edges of the remnant pancreatic stump are passed in the jejunal seromuscular layer and tied. Results : Seventeen patients underwent pancreatojejunostomy after pancreatoduodenectomy for different causes. None developed grade B or C pancreatic fistula. Biochemical leak according to the new definition (International Study Group on Pancreatic Surgery) was observed in four patients (23.5%). No mortality was observed. Conclusion : Early results of this technique confirm that it is simple, reliable, easy to perform, and easy to learn. This technique is useful to reduce the incidence of pancreatic fistula after pancreatoduodenectomy.

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“…Pancreatoduodenectomy after neoadjuvant chemotherapy is the current treatment in patients with borderline pancreatic ductal adenocarcinoma in the head of the pancreas 1 , 2 , 3 . The total mesopancreas excision concept includes the resection of the lymphatic structures on the right side of the SMA and along the neuronal plexus of the pancreatic head.…”

Section: Discussionmentioning

confidence: 99%