Problems of Reconstruction during Pancreatoduodenectomy

Sakorafas, George H.; Frieß, Helmut; Balsiger, Bruno M.; Büchler, Markus W.; Sarr, Michael G.

doi:10.1159/000050174

Cited by 50 publications

(29 citation statements)

References 20 publications

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“…Complications that are related to the pancreatic remnant still represents a substantial risk for death after pancreatic head resections [5][6][7].…”

Section: Discussionmentioning

confidence: 99%

RETRACTED: The Role of Pancreatic Leakage on Rising of Postoperative Complications Following Pancreatic Surgery

Benzoni

Saccomano

Zompicchiatti

et al. 2008

Journal of Surgical Research

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“…Complications that are related to the pancreatic remnant still represents a substantial risk for death after pancreatic head resections [5][6][7].…”

Section: Discussionmentioning

confidence: 99%

RETRACTED: The Role of Pancreatic Leakage on Rising of Postoperative Complications Following Pancreatic Surgery

Benzoni

Saccomano

Zompicchiatti

et al. 2008

Journal of Surgical Research

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“…PJ was associated with a higher rate of extraluminal bleeding as a consequence of damage to the vascular wall by activated proteolytic enzymes, which enter the abdominal cavity through POPF [21]. Throughout the years, multiple studies of different operative techniques for the creation of pancreatic anastomosis and pharmacological prophylactic approaches have been proposed [ [22][23][24][25][26][27]. However, to date, no technique for pancreatic anastomosis has been proven to be the most effective in decreasing rates of pancreatic leakage.…”

Section: Discussionmentioning

confidence: 99%

Turkish Validation and Adaptation of Children ’s Chronotype Questionnaire (CCTQ)

Dursun

Öğütlü

Esın

2015

EAJM

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Objective: The present study aimed to assess the safety of pancreatic anastomosis after pancreaticoduodenectomy (PD) and to compare the results of sutureless pancreatogastrostomy (PG) with those of single-layer duct-to-mucosa pancreatojejunostomy (PJ) after PD in patients with malignant disease of the pancreatic head and of the periampullary region. Materials and Methods:The study included 173 consecutive patients undergoing PD from May 2009 to December 2015 at a single surgical center. Single-layer duct-to-mucosa PJ was performed in 52 patients and sutureless PG in the remaining 123. The primary endpoint was the safety of the procedures, which was assessed as the occurrence of complications during hospitalization. Postoperative pancreatic fistula (POPF) was classified as grade A, B, or C according to the International Study Group of Pancreatic Fistula classification.Results: We found that the incidence of POPF was 11.52%. With regard to POPF, the present study showed no significant difference in the two groups (p=0.043). The incidence of Grade C POPF was significantly higher in the PJ group than in the PG group (p=0.001), which was been reflected in the form of a higher rate of postoperative hemorrhage (p=0.001), intra-abdominal abscess (p=0.012), and septic shock (p=0.012) events in the PJ group. Conclusion:The evaluation of short-term outcomes demonstrates that suturelessPG is a feasible and safe technique, associated with lower life-threatening complications than single-layer duct-to-mucosa PJ. If longterm functional outcomes confirm similar results, sutureless PG could become a valid alternative for pancreatic anastomosis after PD in patients with soft pancreas and high morbidity. Bulgular: Çalışmamızda POPF oranı %11,52 olarak bulundu. İki grup arasında anlamlı bir farklılık görülmedi (p=0,043). Evre C POPF insidansı PJ' de PG grubuna göre anlamlı ölçüde daha yüksekti (p=0,001), Ayrıca PJ grubunda postoperatif hemoraji (p=0,001), intraabdominal apse (p=0,012) ve septik şok (p=0,012) vakalarının oranları da daha yüksek bulundu.Sonuç: Kısa dönem sonuçların değerlendirilmesine göre, tek katlı duct-to-mukozal PJ ile kıyaslandığında dikiş-siz PG daha düşük oranda yaşamı tehdit eden komplikasyonlarından dolayı uygulanabilir ve güvenli bir tekniktir. Uzun dönem fonksiyonel sonuçlarla benzer bulgular doğrulandığı takdirde dikişsiz PG, yumuşak yapılı pankreası ve yüksek morbiditesi olan hastalarda PD sonrası pankreatik anastomoz için geçerli bir alternatif olabilir.

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“…A century later, the phrase ''soft pancreas'' began to gain popularity, as it was discovered to correlate to an increased incidence of postoperative pancreatic leakage [17][18][19]. During the last two decades the number of articles confirming this observation has significantly increased, and currently ''soft pancreas'' is acknowledged as an independent risk factor for an increased rate of pancreatic fistula [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%