Document Detail


Pancreaticoduodenectomy with external drainage of the residual pancreatic duct.
MedLine Citation:
PMID:  8105978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe a new and safe technique for draining the residual pancreatic duct after pancreaticoduodenectomy. DESIGN: Open study. SETTING: University Hospital, Herakleion, Crete. SUBJECTS: Eight patients with histological proved cancer of the periampullary region. INTERVENTIONS: Pancreaticoduodenectomy (Whipple procedure), after which the remnant of the pancreatic duct was not anastomosed to the jejunum but drained externally through a soft polyethylene tube. All patients received total enteral or parenteral nutrition, plus somatostatin. MAIN OUTCOME MEASURES: Avoidance of the high morbidity associated with pancreaticoduodenectomy, in particular pancreatic fistula secondary to leakage from the pancreaticojejunal anastomosis. RESULTS: There was no immediate postoperative mortality or morbidity. The output from the pancreatic remnant decreased progressively, and had ceased in all cases within 20 days; the tube was removed when drainage ceased. Median hospital stay was 24 days (range 20-28). Two patients died after 9 and 11 months, respectively, and the remainder were alive at a median of 26.5 months (range 7-38). Blood glucose concentrations remained within the reference range throughout. CONCLUSION: The technique of external drainage of the pancreatic remnant can safely be combined with a Whipple procedure, ameliorating the risk of postoperative complications and at the same time preserving pancreatic endocrine function.
Authors:
G N Schoretsanitis; D D Tsiftsis; P A Tatoulis; E T Gontikakis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The European journal of surgery = Acta chirurgica     Volume:  159     ISSN:  1102-4151     ISO Abbreviation:  Eur J Surg     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-12-03     Completed Date:  1993-12-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9105264     Medline TA:  Eur J Surg     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  421-4     Citation Subset:  IM    
Affiliation:
Department of Surgical Oncology, University General Hospital, Herakleion, Crete, Greece.
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MeSH Terms
Descriptor/Qualifier:
Aged
Ampulla of Vater / surgery
Bile Duct Neoplasms / surgery
Common Bile Duct Neoplasms / surgery
Drainage / methods
Duodenal Neoplasms / surgery
Female
Humans
Male
Middle Aged
Pancreatic Ducts / surgery*
Pancreatic Fistula / prevention & control
Pancreatic Neoplasms / surgery
Pancreaticoduodenectomy / methods*
Postoperative Complications / prevention & control

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


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