Document Detail


Modified pancreaticoduodenectomy: experience with 81 cases, Wahab modification.
MedLine Citation:
PMID:  11813575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Now pancreaticoduodenectomy is considered a safe and acceptable line of treatment for periampullary tumors. In spite of improvements in the surgical technique it still has a high morbidity rate. In this study we introduce new technical modifications for the original procedure aiming to decrease the incidence of morbidity. METHODOLOGY: Between 1994-2000, 210 pancreaticoduodenectomies were done in the Gastroenterology Center, Mansoura University, Egypt for periampullary tumor. Eighty-one of these patients were subjected to modified pancreaticoduodenectomy. They were 57 men and 34 women with a mean age of 54 (+/- 8) years. Pancreatic carcinoma represented 54%, ampullary tumor 30%, bile duct carcinoma 5% and duodenal carcinoma 1.2%. The mean operative time was 3.7 +/- 0.5 hours and mean estimated blood loss during surgery was 733 +/- 48 mL. RESULTS: Hospital mortality occurred in 3.7% with an overall morbidity rate of 32%. The most common complications were delayed gastric emptying 8.9%, pancreatic fistulae 3.8%, wound infection 6.4%, biliary leakage 3.8% and bleeding 5%. The mean postoperative hospital stay was 9.4 +/- 1 days, with mean time for starting oral feeding 6 +/- 0.9 days. Late mortality occurred in 46% for the entire group with mean follow-up 22 +/- 19 months with actuarial survival for 1, 2, 3, 4, and 5 years being 80, 45, 25, 15, and 10%, respectively. CONCLUSIONS: It was found that this new modification made the operation easier with shorter operative time, less blood transfusion, low incidence of morbidity and short hospital stay. Moreover, it takes the advantages of lowering the incidence of biliary gastritis, cholangitis and peptic ulcer.
Authors:
M Abdel-Wahab; A Sultan; N elGwalby; O Fathy; A AboElenen; M A Zied; A Fouad; T A Allah; G el-Ebiedy; N Gad-ElHak; A Elfiky; F Ezzat
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  48     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2001 Nov-Dec
Date Detail:
Created Date:  2002-01-29     Completed Date:  2002-06-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1572-6     Citation Subset:  IM    
Affiliation:
Gastroenterology Center, Mansoura University, Mansoura, Egypt. Wahabmeg@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Male
Middle Aged
Pancreatic Neoplasms / surgery*
Pancreaticoduodenectomy / adverse effects,  methods*,  mortality
Retrospective Studies

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