Pancreatic fistula after pancreatic head resection

2000 ◽  
Vol 87 (7) ◽  
pp. 883-889 ◽  
Author(s):  
M. W. Büchler ◽  
H. Friess ◽  
M. Wagner ◽  
C. Kulli ◽  
V. Wagener ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Pancreatic Head ◽  
Pancreatic Head Resection

scholarly journals The modified Blumgart anastomosis after pancreaticoduodenectomy: a retrospective single center cohort study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Georgi Kalev ◽  
Christoph Marquardt ◽  
Herbert Matzke ◽  
Paul Matovu ◽  
Thomas Schiedeck
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Pancreatic Fistula ◽  
Pancreatic Head ◽  
Suture Technique ◽  
Postoperative Pancreatic Fistula ◽  
Intermediate Care ◽  
Pancreatic Head Resection ◽  
Pancreatic Anastomosis

AbstractObjectivesThe postoperative pancreatic fistula (POPF) is a major complication after pancreatic head resection whereby the technique of the anastomosis is a very influencing factor. The literature describes a possible protective role of the Blumgart anastomosis.MethodsPatients after pancreatic head resection with reconstruction through the modified Blumgart anastomosis (a 2 row pancreatic anastomosis through mattress sutures of the parenchyma and duct to mucosa pancreaticojejunostomy, Blumgart-group) were compared with patients after pancreatic head resection and reconstruction through the conventional pancreatojejunostomy (single suture technique of capsule and parenchyma to seromuscularis, PJ-group). The Data were collected retrospectively. Depending on the propensity score matching in a ratio of 1:2 comparison groups were set up. Blumgart-group (n=29) and PJ-group (n=56). The primary end point was the rate of POPF. Secondary goals were duration of operation, length of hospital stay, length of stay on intermediate care units and hospital mortality.ResultsThe rate of POPF (biochemical leak, POPF “grade B” and POPF “grade C”) was less in the Blumgart-group, but without statistical relevance (p=0.23). Significantly less was the rate of POPF “grade C” in the Blumgart-group (p=0.03). Regarding the duration of hospital stay, length of stay on intermediate care units and hospital mortality, there was no relevant statistical difference between the groups (p=0.1; p=0.4; p=0.7). The duration of the operation was significantly less in the Blumgart-group (p=0.001).ConclusionsThe modified Blumgart anastomosis technique may have the potential to decrease major postoperative pancreatic fistula.

Pancreatic fistula after pancreatic head resection: A problem of the past?

2003 ◽  
Vol 124 (4) ◽  
pp. A822
Author(s):  
Helmut Friess ◽  
Jorg Kleeff ◽  
Lars Fischer ◽  
Kaspar Zgraggen ◽  
Jan Schmidt ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Pancreatic Head ◽  
Pancreatic Head Resection ◽  
The Past

scholarly journals DUODENUM-PRESERVING PANCREATIC HEAD RESECTION FOR CHRONIC PANCREATITIS, BENIGN AND PREMALIGNANT TUMORS OF THE PANCREAS

2021 ◽  
Vol 29 (2) ◽  
pp. 257-265
Author(s):  
G. Beger Hans ◽  
◽  
◽  
Link Karl-Heinz ◽  
V.A. Asanovich ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Pancreatic Fistula ◽  
Neuroendocrine Tumors ◽  
Pancreatic Head ◽  
Jejunal Loop ◽  
Pancreatic Head Resection ◽  
Cystic Neoplasms ◽  
Metabolic Complications ◽  
Whipple Resection

Objective. To report the institutional experience of the evolution of duodenum-preserving pancreatic head resection (DPPHR) as a surgical treatment for chronic pancreatitis with an inflammatory tumor as well as cystic and benign, premalignant neoplasms and neuroendocrine tumors of the pancreatic head. Methods. DPPHR is associated with preservation of gastric antrum, common bile duct and duodenum/upper jejunal loop, contrary to Kausch-Whipple resection, which is a multivisceral procedure, including duodenectomy. Duodenum-preserving pancreatic head resection was first established in clinical setting in Berlin in 1969. Results. For chronic pancreatitis with an inflammatory infiltrat in the pancreatic head, duodenum-preserving pancreatic head resection has become a standard surgical treatment with worldwide acceptance. In a series of 603 patients with chronic pancreatitis following DPPHR, the frequency of pancreatic fistula was 3.3 %, intra-abdominal abscess 2.8 %, hemorrhage 2.8 %, frequency of reoperation 5.6%, in-hospital mortality 0.82 % and 90-day rehospitalisation 8 %. DPPHR for benign and premalignant cystic neoplasms of the pancreatic head is used predominantly for IPMN, MCN and SPN tumors. In a review of international publications comprising 503 patients, the general morbidity was 38.2 %, severe surgery-related complications 12.7% of them pancreatic fistula B+C 13.6 %, resurgery 2.7 % and 90-day mortality 0.4 %. When pancreatic neuroendocrine tumors of pancreatic head are treated with DPPHR, a local lymph node dissection is additionally recommended. The long-term morbidity following DPPHR revealed new onset of diabetes mellitus and exocrine dysfunctions in only 5-7 % of patients. Conclusion. Kausch-Whipple resection is associated with considerable high metabolic complications. Duodenum-sparing pancreatic head resection for inflammatory tumor, benign and premalignant neoplasms, and neuroendocrine tumors of the pancreatic head has the advantage of the duodenum preservation and maintenance of the pancreatic endocrine and exocrine functions.

scholarly journals Anatomy-Specific Pancreatic Stump Management to Reduce the Risk of Pancreatic Fistula After Pancreatic Head Resection

2009 ◽  
Vol 33 (10) ◽  
pp. 2166-2176 ◽  
Author(s):  
Yoshitsugu Tajima ◽  
Tamotsu Kuroki ◽  
Noritsugu Tsuneoka ◽  
Tomohiko Adachi ◽  
Taiichiro Kosaka ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Pancreatic Head ◽  
Pancreatic Head Resection ◽  
Pancreatic Stump

scholarly journals Vascular anomalies in pancreatic head resection do not impact surgical outcome in high volume center

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S299
Author(s):  
I. Frigerio ◽  
S. Mancini ◽  
V. Allegrini ◽  
A. Giardino ◽  
P. Regi ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Pancreatic Head ◽  
High Volume ◽  
Vascular Anomalies ◽  
Pancreatic Head Resection ◽  
High Volume Center

Intraoperative bile duct cultures in patients undergoing pancreatic head resection: Prospective comparison of bile duct swab versus bile duct aspiration

Surgery ◽  
2021 ◽  
Author(s):  
Jennifer A. Yonkus ◽  
Roberto Alva-Ruiz ◽  
Amro M. Abdelrahman ◽  
Susan E. Horsman ◽  
Scott A. Cunningham ◽  
...  
Keyword(s):  
Bile Duct ◽  
Pancreatic Head ◽  
Pancreatic Head Resection ◽  
Prospective Comparison

Laparoscopic duodenum-preserving total pancreatic head resection: a novel surgical approach for benign or low-grade malignant tumors

2018 ◽  
Vol 33 (2) ◽  
pp. 633-638 ◽  
Author(s):  
Jun Cao ◽  
Guo-lin Li ◽  
Jin-xing Wei ◽  
Wei-Bang Yang ◽  
Chang-zhen Shang ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Malignant Tumors ◽  
Pancreatic Head ◽  
Low Grade ◽  
Pancreatic Head Resection

scholarly journals Pancreatic exocrine function after pancreatic head resection using stable isotope

Suizo ◽  
2017 ◽  
Vol 32 (4) ◽  
pp. 687-692
Author(s):  
Hironobu YASUOKA ◽  
Akihiko HORIGUCHI ◽  
Masahiro ITO ◽  
Yukio ASANO ◽  
Toki KAWAI
Keyword(s):  
Stable Isotope ◽  
Pancreatic Head ◽  
Pancreatic Exocrine Function ◽  
Exocrine Function ◽  
Pancreatic Head Resection ◽  
Pancreatic Exocrine

scholarly journals Pancreatic fistulae following pancreatic resection. Analysis of causes and prevention methods

2018 ◽  
Vol 22 (4) ◽  
pp. 640-646
Author(s):  
K.G. Valikhnovska
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Pancreatic Duct ◽  
Pancreatic Resection ◽  
Pancreatic Head ◽  
Preoperative Period ◽  
External Drainage ◽  
Distal Pancreatic Resection ◽  
Glycemic Level ◽  
Prevention Methods

The causes of pancreatic fistula were analyzed in 503 patients aged from 22 to 81who underwent pancreaticoduodenectomy for pancreatic and periampullary tumors. The said patients were operated on during the period from 2008 to 2017. The aim of this study is to improve the outcomes of pancreatic resection based on a retrospective analysis of the risk factors of postoperative pancreatic fistulae and the development of a range of measures to prevent the above complication. The influence of factors on the risk of pancreatic fistula was investigated by Pearson method (χ2). The factors contributing to the occurrence of pancreatic fistulae included type of resection (Whipple pancreaticoduodenectomy, pylorus preserving pancreaticoduodenectomy; χ2=8.616,1, p=0.0033, p<0.01), kind of pathology (cancer of the pancreatic head, χ2=7.658,1, p=0.0057, p<0.01), type of pancreaticojejunostomy (invaginative pancreatic duct-jejunostomy; χ2=12.75,1, p<0.001), technique for drainage of the major pancreatic duct (pancreaticojejunostomy on external drainage, χ2=44.01,1, p<0.0001), resection of venous vessels following distal pancreatic resection (χ2=8.350,1, p=0.0039, p<0.01), glycemic level in the preoperative period (P=0.0344,U=15061), the presence of concomitant diseases in patients (χ2=15.62,1, p=0.0001, p<0.001). Preoperative glycemic level and the presence of concomitant diseases in patients are factors that can be influenced to prevent the onset of pancreatic fistula in the postoperative period in patients who are scheduled for pancreatic resection. Prevention of this complication involves the correction of glycemic level and treatment of concomitant pathology in patients in the preoperative period.

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