Document Detail


Pancreatic transection using ultrasonic dissector in pancreatoduodenectomy.
MedLine Citation:
PMID:  11587688     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pancreatoenterostomic leakage after pancreatoduodenectomy may be caused partly by pancreatic juice leakage from transected branch pancreatic ducts on the pancreatic cut surface that do not drain into the main pancreatic duct after pancreatectomy. METHODS:We devised a new technique of pancreatic transection using an ultrasonic dissector followed by duct-to-mucosa pancreatojejunostomy, in order to prevent pancreatoenterostomic leakage after pancreatoduodenectomy in patients with a soft pancreas and a small main pancreatic duct. During pancreatic transection, branch pancreatic ducts and blood vessels are adequately skeletonized and securely ligated. The pancreatic duct is anastomosed to the full thickness of the jejunum with four to six interrupted sutures. RESULTS: Ten patients with a nondilated pancreatic duct (2 to 3 mm) underwent pancreatoduodenectomy by the present method. During pancreatic transection, 24 to 35 ducts including the pancreatic ducts and blood vessels were skeletonized and ligated. Postoperatively, no patients developed pancreatojejunostomic leakage. The present method may prevent pancreatoenterostomic leakage after pancreatoduodenectomy.
Authors:
M Sugiyama; N Abe; Y Izumisato; M Tokuhara; T Masaki; T Mori; Y Atomi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  182     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-10-05     Completed Date:  2001-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  257-9     Citation Subset:  AIM; IM    
Affiliation:
First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, 181-8611, Tokyo, Japan. sgym@kyorin-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical
Duodenum / surgery
Humans
Pancreas / surgery*
Pancreatectomy / methods*
Pancreatic Ducts / surgery
Pancreaticoduodenectomy / methods*
Postoperative Complications / prevention & control
Ultrasonic Therapy / instrumentation*

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


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