Document Detail


Fistulation method: simple and safe pancreaticojejunostomy after pancreatoduodenectomy.
MedLine Citation:
PMID:  10776435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A pancreatic leak from the pancreaticojejunostomy after pancreatoduodenectomy has a potential risk of serious complications. We devised a simplified fistulation method for pancreaticojejunostomy. METHODS: The fistulation method, which uses a pancreatic drainage tube as a stent without pancreatic duct-to-jejunal mucosa anastomosis, was applied to 162 consecutive patients. They were divided into 3 groups according to the state of the pancreatic remnant: group 1, soft and normal parenchyma (n = 71); group 2, firm and thickened parenchyma (n = 40); group 3, hard and atrophic parenchyma (n = 51). The consistency in relation to the incidence of pancreatic leak and mortality were analyzed. Morphologic changes of the pancreatic remnant in long-term survivors of group 1 were assessed with computed tomography. RESULTS: A pancreatic leak occurred in 3 patients from group 1, in 2 patients from group 2, and in no patients from group 3 (leak rate, 3%). No operative mortality and 5 hospital deaths (3%) unrelated to a pancreatic leak were observed. The parenchyma of the pancreatic remnant was well preserved in 52% of the long-term survivors and the pancreatic duct was not dilated in 63%. CONCLUSIONS: The fistulation method can be performed safely and easily regardless of the state of the pancreatic remnant, and it provides every surgeon with a low incidence of pancreatic leak among patients.
Authors:
A Okamoto; K Tsuruta
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  127     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-05-08     Completed Date:  2000-05-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  433-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Tokyo Metropolitan Komagome Hospital, Japan.
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Drainage
Follow-Up Studies
Humans
Pancreaticoduodenectomy*
Pancreaticojejunostomy / adverse effects,  methods*,  mortality
Postoperative Complications / classification,  epidemiology
Retrospective Studies
Safety
Stents
Surgical Wound Infection / epidemiology
Survival Analysis
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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