أعضاء هيئة التدريس - جامعة بنها
Reconstruction Methods After Pancreaticoduodenectomy For Pancreatic Carcinoma; Which Better To Prevent Serious Complications
• 2014
معلومات البحث
المؤلفون
Hamed Rashad,a MD; El-Sayed A. Abd El-Mabood, a MD; Taher H. Elwan, a MD; Ayman M. Adbelmofeed, a MD; Refaat S. Salama, a MD;
Emad H. Gad, b MD;
الكلمات المفتاحية
Pancreatic carcinoma, pancreaticoduodenectomy, pancreaticogastrostomy, pancreaticojejunostomy, morbidity.
المجلة العلمية
Not Available
الناشر
Not Available
المجلد
Not Available
العدد
Not Available
الصفحات
Not Available
publication.type
International
رابط البحث
Not Available
المواد المرفقة
Not Available
الملخص
Purposes: The aim of this study was to assess the safety of the pancreatic anastomosis after pancreatico-duodenectomy (PD) & to compare the results of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) following pancreaticoduodenectomy in a prospective and randomized setting.
Background: Pancreatic fistula after pancreaticoduodenectomy represents a critical trigger of potentially life-threatening complications and is also associated with markedly prolonged hospitalization. The best method for dealing with the pancreatic stump after pancreaticoduodenectomy remains in question.
Patients and methods: The study included 50 patients; 33 (64%) males and 18 (36%) females with mean age of 66.3+4 years. All patients underwent clinical evaluation, laboratory assessment and CT or MRI examination. All patients undergoing pancreaticoduodenectomy with soft residual tissue were randomized to receive either pancreaticogastrostomy (group PG) or end-to-side pancreaticojejunostomy (group PJ). The postoperative follow up ranged from 6 months to 12 months.
Results: No mortality were recorded. Mean ICU stay duration was 2.4+0.8 days. The duration of hospital & ICU stay was shorter in group PG (P-value =0.03); The mortality due to surgical causes was higher in group PJ (P-value =0.02); The frequency of post operative complications i.e. pancreatic fistula (P-value =0.0343), intra-abdominal bleeding & collection (P-value =0.0376) were higher in group PJ; But there is no significance between both groups in the frequency of Abdominal wall abscess & biliary leakage (P-value =0.39). The cases of Intra-abdominal collection were treated well by conservative measures in group PG (P-value =0.023); But cases that needed open drainage were less (P-value =0.0376) & there was no significance between both groups in CT guided drainage (P-value =0.56).
Conclusions: Pancreaticogastrostomy could be considered better as a reconstruction method; with shorter hospital stay, No Necrosis of pancreatic remnant, Less frequency of post operative complications & So Re-do with its complication is also less.
Background: Pancreatic fistula after pancreaticoduodenectomy represents a critical trigger of potentially life-threatening complications and is also associated with markedly prolonged hospitalization. The best method for dealing with the pancreatic stump after pancreaticoduodenectomy remains in question.
Patients and methods: The study included 50 patients; 33 (64%) males and 18 (36%) females with mean age of 66.3+4 years. All patients underwent clinical evaluation, laboratory assessment and CT or MRI examination. All patients undergoing pancreaticoduodenectomy with soft residual tissue were randomized to receive either pancreaticogastrostomy (group PG) or end-to-side pancreaticojejunostomy (group PJ). The postoperative follow up ranged from 6 months to 12 months.
Results: No mortality were recorded. Mean ICU stay duration was 2.4+0.8 days. The duration of hospital & ICU stay was shorter in group PG (P-value =0.03); The mortality due to surgical causes was higher in group PJ (P-value =0.02); The frequency of post operative complications i.e. pancreatic fistula (P-value =0.0343), intra-abdominal bleeding & collection (P-value =0.0376) were higher in group PJ; But there is no significance between both groups in the frequency of Abdominal wall abscess & biliary leakage (P-value =0.39). The cases of Intra-abdominal collection were treated well by conservative measures in group PG (P-value =0.023); But cases that needed open drainage were less (P-value =0.0376) & there was no significance between both groups in CT guided drainage (P-value =0.56).
Conclusions: Pancreaticogastrostomy could be considered better as a reconstruction method; with shorter hospital stay, No Necrosis of pancreatic remnant, Less frequency of post operative complications & So Re-do with its complication is also less.