Regional vessels wrapping following pancreaticoduodenectomy reduces the risk of post-operative extra-luminal bleeding. A systematic review

Nour, Hussameldin M; Peristeri, Dimitra; Ahsan, Amiya; Shafique, Shehram; Khan, Prof Mansoor; Sajid, M. S.

doi:10.1016/j.amsu.2022.104618

Cited by 5 publications

(8 citation statements)

References 26 publications

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“…According to the ISGPS standard, the incidence of postoperative pancreatic stula in our center was 38.5% for the total surgery. This value is higher than that of other scholars [13], which may be due to the deviation caused by the lack of early surgical experience and may be improved in more cases in the future. Ten cases of pancreaticojejunostomy bleeding or GDA stump bleeding due to clinical pancreatic stula (postoperative bleeding rate accounted for 6.8% of the total operation).…”

Section: Discussioncontrasting

confidence: 56%

“…Bleeding from the gastroduodenal artery (GDA) stump is a signi cant risk after PD and may lead to the need for reoperation or death [4][5][6][7][8][9][10]. The bleeding is often caused by pancreatic stula and corrosion of blood vessels or local in ammation [3,8,[11][12][13]. In recent years, the use of somatostatin and octreotide has signi cantly decreased the bleeding incidence [3]; nevertheless, massive bleeding caused by pancreatic stula remains at 16-40% [10,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Ligamentum teres hepatis wrapping of the gastroduodenal artery stump protection in total laparoscopic pancreaticoduodenectomy: a single-center experience

et al. 2023

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Background Stump hemorrhage of the gastroduodenal artery (GDA) is a significant postoperative risk of pancreaticoduodenectomy (PD). We determined whether wrapping the GDA stump with the ligamentum teres hepatis (LTH) would reduce postoperative pancreaticoduodenal bleeding. Methods We retrospectively reviewed 148 patients who underwent laparoscopic pancreatoduodenectomy (LPD) at Li Huili Hospital of Ningbo Medical Center from November 2015 to September 2021. We compared perioperative data from 63 LPD patients without wrapping of the GDA (the unwrapped group) and 85 whose GDA stumps were wrapped (the wrapping group). Results There was no significant difference in the groups' baseline characteristics. The postoperative GDA stump bleeding incidence was significantly lower in the wrapped group than in the unwrapped group (7.9% vs. 0% p = 0.013). There was no significant difference in the incidence of other complications (e.g., intraabdominal infection, pancreatic fistula, biliary fistula, and gastrointestinal bleeding). Conclusions Using the LTH to wrap the GDA stump during LPD can reduce bleeding from the GDA stump but not the incidence of other complications.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Ligamentum teres hepatis wrapping of the gastroduodenal artery stump protection in total laparoscopic pancreaticoduodenectomy: a single-center experience

et al. 2023

Preprint

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“…The chosen wrap is carefully positioned to cover the major arteries and veins and secured in place with nonabsorbable sutures. From the above options for the protection of divided or skeletonized vessels, the use of a teres/falciform ligament has become the most frequently applied technique due to evidence for its effectiveness in published case series [29][30][31][32][33], systematic reviews [34][35][36], and a recent randomized clinical trial [37].…”

Section: Peripancreatic Vessel Wrapmentioning

confidence: 99%

Surgical Options to Mitigate the Consequences of Pancreatic Anastomosis Leak after Pancreaticoduodenectomy

Saroglu¹,

Julianov²

2023

Pancreatic Cancer- Updates in Pathogenesis, Diagnosis and Therapies

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Pancreaticoduodenectomy is still the only treatment option that offers a chance to cure patients with pancreatic cancer and malignant periampullary tumors. Pancreaticojejunal anastomosis is the preferred method of reconstruction after pancreaticoduodenectomy. However, because of the high incidence of anastomotic leak and subsequent severe consequences, pancreaticojejunal anastomosis still remains the Achilles’ heel of the operation. Several technical modifications of pancreaticojejunal anastomosis exist, but none completely eliminates anastomotic leak, postoperative pancreatic fistula, or severe complications. Therefore, considerable efforts have been made to study and develop surgical options that can mitigate the severity and avoid fatal consequences of postoperative pancreatic fistula. This chapter presents and discusses some of the existing and emerging surgical strategies devoted to mitigating the catastrophic consequences of pancreatic anastomotic leaks.

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“…Bleeding from the gastroduodenal artery (GDA) stump is a major risk after PD and may lead to the need for reoperation or death [4][5][6][7][8][9][10]. The bleeding is often caused by pancreatic stula and corrosion of blood vessels or local in ammation [3,8,[11][12][13]. In recent years, the use of somatostatin and octreotide has signi cantly decreased the bleeding incidence [3]; nevertheless, massive bleeding caused by pancreatic stula remains at 16-40% [10,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Ligamentum teres hepatis wrapping of the gastroduodenal artery stump protection during pancreaticoduodenectomy: a single-center experience

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Stump hemorrhage of the gastroduodenal artery (GDA) is a major postoperative risk of pancreaticoduodenectomy (PD). We determined whether wrapping the GDA stump with the ligamentum teres hepatis (LTH) would reduce postoperative pancreaticoduodenal bleeding. Methods We retrospectively reviewed 148 patients who underwent PD at Li Huili Hospital of Ningbo Medical Center from November 2015 to September 2021. We compared perioperative data from 63 PD patients without wrapping of the GDA (the unwrapped group) and 85 whose GDA stump were wrapped (the wrapping group). Results There was no significant difference in the groups' baseline characteristics. The postoperative GDA stump bleeding incidence was significantly lower in the wrapped group than in the unwrapped group (7.9% vs. 0% p = 0.013). There was no significant difference in the incidence of other complications (e.g., intraabdominal infection, pancreatic fistula, biliary fistula, and gastrointestinal bleeding). Conclusions Using the LTH to wrap the GDA stump during PD can reduce the incidence of bleeding from the GDA stump but not the incidence of other complications.

show abstract

Regional vessels wrapping following pancreaticoduodenectomy reduces the risk of post-operative extra-luminal bleeding. A systematic review

Cited by 5 publications

References 26 publications

Ligamentum teres hepatis wrapping of the gastroduodenal artery stump protection in total laparoscopic pancreaticoduodenectomy: a single-center experience

Ligamentum teres hepatis wrapping of the gastroduodenal artery stump protection in total laparoscopic pancreaticoduodenectomy: a single-center experience

Surgical Options to Mitigate the Consequences of Pancreatic Anastomosis Leak after Pancreaticoduodenectomy

Ligamentum teres hepatis wrapping of the gastroduodenal artery stump protection during pancreaticoduodenectomy: a single-center experience

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