Limits...
A new option for treatment of postoperative pancraticojejunal anstomosis leakage in pancraticoduodenectomy: Easy and safe.

Tabatabaee SA, Hashemi SM, Fazel M, Dadkhah S, Jazi AD - J Res Med Sci (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Sir, Among the tumors affecting gastrointestinal tract pancreatic head and peri-ampullary cancer may show remarkable morbidity and mortality because of its significant structure and function... Obstructive jaundice is a common symptom of patients suffering from peri-ampullary and pancreatic head tumors... The best procedure for treatment of these patients is pancreaticoduodenectomy (PD)... Among the tumors affecting gastrointestinal tract pancreatic head and peri-ampullary cancer may show remarkable morbidity and mortality because of its significant structure and function... Previous studies showed that in some situations this procedure should not be performed for example: Distant tissues affecting with tumoral metastasis, mesenteric and portal vessels affecting and also invasion of tumoral mass to small bowel... In the past 20 years significant improvement in reducing the mortality rate of the procedure in high technology centers occurred... But high morbidity rate of the procedure perioperatively is still a major devastating issue... It should be considered as the most important factor impresses the morbidity and mortality rate in the patients undergone the procedure... Expected complication of this approach to the pancreatic leak is to inability to maintain the pancreatic exocrine function... It can simply be resolved by long life administration of oral pancreatic enzymes as we did for the patients without any clinically important side effects... In addition due to preservation of pancreatic blood supply it can be conclude than endocrine pancreatic hormones probably remain intact after pancreatic closure... Despite this techniques could not preserved pancreatic exocrine function, however, instead the patient's life may saved by scarifying pancreaticojejunal anastomosis... Further studies should be performed to evaluate the short term and long term outcomes of this technique.

No MeSH data available.


Pancreas and adjacent jejunum was debrided and pancreatic stamp, as well as jejunal stamp were closed by interrupted sutures
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4061654&req=5

Figure 1: Pancreas and adjacent jejunum was debrided and pancreatic stamp, as well as jejunal stamp were closed by interrupted sutures

Mentions: After operating 42 patients suffering from pancreatic head malignancy with Whipple procedure in Al-Zahra hospital, department of surgery, pancreaticojejunal anastomosis leakage were reported in 4 cases including 3 men and a woman. In 2 cases (a man and a woman) 5-7 days postoperatively, after peritoneal washing, pancreas debridement is done and it was anastomosed to the stomach. One of the patients was expired and the other was discharged without any major complication. For remained cases (two 70-year-old men) pancreas and adjacent jejunum was debrided and pancreatic stamp as well as jejunal stamp were closed by interrupted sutures [Figure 1]. Both the patients were discharged from the hospital by satisfactory general condition. One of them showed no blood glucose abnormality during the one year period of follow-up. But the other affected by diabetes controlled by oral hypoglycemic agent.


A new option for treatment of postoperative pancraticojejunal anstomosis leakage in pancraticoduodenectomy: Easy and safe.

Tabatabaee SA, Hashemi SM, Fazel M, Dadkhah S, Jazi AD - J Res Med Sci (2014)

Pancreas and adjacent jejunum was debrided and pancreatic stamp, as well as jejunal stamp were closed by interrupted sutures
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061654&req=5

Figure 1: Pancreas and adjacent jejunum was debrided and pancreatic stamp, as well as jejunal stamp were closed by interrupted sutures
Mentions: After operating 42 patients suffering from pancreatic head malignancy with Whipple procedure in Al-Zahra hospital, department of surgery, pancreaticojejunal anastomosis leakage were reported in 4 cases including 3 men and a woman. In 2 cases (a man and a woman) 5-7 days postoperatively, after peritoneal washing, pancreas debridement is done and it was anastomosed to the stomach. One of the patients was expired and the other was discharged without any major complication. For remained cases (two 70-year-old men) pancreas and adjacent jejunum was debrided and pancreatic stamp as well as jejunal stamp were closed by interrupted sutures [Figure 1]. Both the patients were discharged from the hospital by satisfactory general condition. One of them showed no blood glucose abnormality during the one year period of follow-up. But the other affected by diabetes controlled by oral hypoglycemic agent.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Sir, Among the tumors affecting gastrointestinal tract pancreatic head and peri-ampullary cancer may show remarkable morbidity and mortality because of its significant structure and function... Obstructive jaundice is a common symptom of patients suffering from peri-ampullary and pancreatic head tumors... The best procedure for treatment of these patients is pancreaticoduodenectomy (PD)... Among the tumors affecting gastrointestinal tract pancreatic head and peri-ampullary cancer may show remarkable morbidity and mortality because of its significant structure and function... Previous studies showed that in some situations this procedure should not be performed for example: Distant tissues affecting with tumoral metastasis, mesenteric and portal vessels affecting and also invasion of tumoral mass to small bowel... In the past 20 years significant improvement in reducing the mortality rate of the procedure in high technology centers occurred... But high morbidity rate of the procedure perioperatively is still a major devastating issue... It should be considered as the most important factor impresses the morbidity and mortality rate in the patients undergone the procedure... Expected complication of this approach to the pancreatic leak is to inability to maintain the pancreatic exocrine function... It can simply be resolved by long life administration of oral pancreatic enzymes as we did for the patients without any clinically important side effects... In addition due to preservation of pancreatic blood supply it can be conclude than endocrine pancreatic hormones probably remain intact after pancreatic closure... Despite this techniques could not preserved pancreatic exocrine function, however, instead the patient's life may saved by scarifying pancreaticojejunal anastomosis... Further studies should be performed to evaluate the short term and long term outcomes of this technique.

No MeSH data available.