Document Detail


Salvage pancreaticogastrostomy for pancreatic fistulae after pancreaticoduodenectomy.
MedLine Citation:
PMID:  22923318     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Pancreatic anastomotic dehiscence after pancreaticoduodenectomy (PD) remains a common problem. Although the management of this condition is mostly conservative, some patients require surgical intervention. This study reviews our experience with surgical intervention in this clinical setting. All patients who underwent PD by the author between 1999 and 2011 were reviewed. The causes for reoperation and mortality after PD were evaluated. The nature of the operative intervention and outcome in those who underwent reoperation for postoperative pancreatic fistula were analyzed. Reoperation was necessary in a total of 36/208 patients in this series and the overall mortality for the entire series was 6.25 % (13/208). Twelve of these 36 reoperations in 208 patients were for treatment of pancreatic anastomotic dehiscence after PD. Five (42 %) patients reoperated for anastomotic dehiscence died, including four of six patients that underwent surgical drainage of percutaneously inaccessible collections and one of two patients that underwent completion pancreatectomy. None of those who underwent salvage pancreaticogastrostomy (PG) died, nor did they require additional interventions prior to discharge from hospital. In our experience, salvage PG was an effective and organ function preserving technique to manage pancreatic anastomotic dehiscence after PD.
Authors:
Sanjay Govil
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-28
Journal Detail:
Title:  Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology     Volume:  -     ISSN:  0975-0711     ISO Abbreviation:  Indian J Gastroenterol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8409436     Medline TA:  Indian J Gastroenterol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Bangalore Institute of Oncology Specialty Centre, HCG Towers, #8 P. Kalinga Rao Road, Sampangiram Nagar, Bangalore, 560 027, India, s4govil@gmail.com.
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