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The Complications Of Pancreatectomy

M. Trede, B. Chir., Gunther Schwall
Published 1988 · Medicine

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This paper analyses the early postoperative complications after 285 pancreaticoduodenectomies performed during the past 15 years in the Surgical University Clinic, Mannheim. There were 235 partial (Whipple) and 52 total pancreatectomies performed for pancreatic and periampullary tumors (181 patients) and complicated chronic pancreatitis (104 patients). A total of 92 complications requiring relaparotomy in 42 patients ended fatally in nine patients. The overall operative and hospital mortality rate was 3.1%. The most frequent and most dangerous were complications at or around the pancreaticojejunal anastomosis, which occurred 25 times with five deaths. Postoperative hemorrhage was seen in 16 patients; endoscopic treatment in four patients and operation in 12 patients was successful in stopping the bleeding in all but one patient. Eight biliary fistulae either ceased spontaneously (3 patients) or after operative reintervention (5 patients) without any mortality. Control of these complications depends on four lines of approach: (1) before operation: optimal preparation of the jaundiced patient including endoscopic transpapillary decompression of the common duct; (2) during operation: a meticulous and standardized technique is mandatory; (3) after operation: continous observation in the surgical intensive care unit is essential for the timely detection of possible complications; and (4) early reintervention can salvage the great majority of these patients with deleterious complications.



This paper is referenced by
10.3748/WJG.V11.I16.2456
Risk factors of pancreatic leakage after pancreaticoduodenectomy.
Yin-mo Yang (2005)
10.1007/978-3-642-79167-3
Facing the Pancreatic Dilemma
P. Pederzoli (1994)
10.1007/978-1-4471-4354-3_4
Diagnosis and Treatment of Major Abdominal Complications Is Multidisciplinary Work
D. J. Gouma (2014)
10.3748/wjg.v23.i5.919
Pancreaticoduodenectomy: Secondary stenting of the celiac trunk after inefficient median arcuate ligament release and reoperation as an alternative to simultaneous hepatic artery reconstruction
Théophile Guilbaud (2017)
10.1016/j.ijsu.2014.11.034
Pancreaticojejunostomy with double-layer continuous suturing is associated with a lower risk of pancreatic fistula after pancreaticoduodenectomy: a comparative study.
Weiping Ji (2015)
10.1007/s00595-011-0097-1
Delayed gastric emptying improved by straight stomach reconstruction with twisted anastomosis to the jejunum after pylorus-preserving pancreaticoduodenectomy (PPPD) in 118 consecutive patients at a single institution
T. Masui (2011)
10.1136/gut.42.2.293
Conclusive evidence of endotoxaemia in biliary obstruction
W. Clements (1998)
Lessons learned from 100 personal consecutive cases of pancreaticoduodenectomy at a university hospital in Thailand.
S. Sriussadaporn (2013)
Early identification of postoperative pancreatic fistula may reduce the risk of postoperative hemorrhage in pancreatic resected patients.
R. Pezzilli (2007)
10.1097/SLA.0b013e31814a6906
Fatty Pancreas: A Factor in Postoperative Pancreatic Fistula
A. Mathur (2007)
10.1016/j.ijsu.2014.05.060
Enteric reconstruction of pancreatic stump following pancreaticoduodenectomy: a review of the literature.
Y. Chen (2014)
10.3919/JJSA.60.2484
LATE ONSET OF ACUTE GENERALIZED PERITONITIS CAUSED BY INFLAMMATION OF THE REMNANT PANCREAS AFTER PYLORUS PRESERVING PANCREATODUODENECTOMY-A CASE REPORT-
M. Oikawa (1999)
10.1177/096368970000900103
The Risks of Total Pancreatectomy and Splenic Islet Autotransplantation 1
S. A. White (2000)
10.1007/978-1-4757-4371-5_22
Treatment of Pancreatic Exocrine Disorders by Pancreas and Islet Transplantation
R. Gruessner (2004)
10.1016/J.AMJSURG.2005.09.012
Toward zero pancreatic fistula after pancreaticoduodenectomy with pancreaticogastrostomy.
E. Rosso (2006)
10.1159/000050178
Outcome following Pancreaticoduodenectomy in Patients Undergoing Preoperative Biliary Drainage / with Invited Commentary
S. Srivastava (2001)
10.1007/978-4-431-68541-8_48
Pancreatoduodenectomy for Periampullary Carcinoma: Experience with 320 Cases
Y. Liu (1997)
10.1067/MGE.2002.123278
Biliary drainage by endoscopic choledochoduodenal fistulotomy in patients with papillary carcinoma.
J. J. Park (2002)
10.1007/s00268-001-0249-3
Relation of Biliary Bile Acid Output to Hepatic Adenosine Triphosphate Level and Biliary Indocyanine Green Excretion in Humans
K. Chijiiwa (2002)
10.6092/1590-8577/2996
Diagnosis and Management of Haemorrhagic Complications Following Hepatopancreatobiliary Surgery
A. Balakrishnan (2015)
10.1001/ARCHSURG.139.3.288
Octreotide in the prevention of intra-abdominal complications following elective pancreatic resection: a prospective, multicenter randomized controlled trial.
B. Suc (2004)
10.1016/j.jvir.2011.12.013
Superselective embolization for the management of postpancreatectomy hemorrhage: a single-center experience in 25 patients.
U. Stampfl (2012)
10.3109/9781420015218-13
Complications of Abdominal Wall Surgery and Hernia Repair
J. Doherty (2006)
10.1159/000096244
Triple-Layer Duct-to-Mucosa Pancreaticojejunostomy after Pancreaticoduodenectomy
S. Ibrahim (2006)
10.1007/978-3-642-97487-8
Radiology of the Pancreas
P. Dubois (1989)
10.3748/WJG.15.2908
Ampullary carcinoma: effect of preoperative biliary drainage on surgical outcome.
S. A. Abdullah (2009)
10.1016/B978-1-4160-3256-4.50019-3
Infections in Hepatic, Biliary, and Pancreatic Surgery
C. Schmidt (2007)
10.1080/02841859809172200
Hepatic parenchymal perfusion abnormalities after pancreaticobiliary surgery
K. Mitsuzaki (1998)
10.1016/S1365-182X(17)30774-8
Increased bacterobilia associated with preoperative biliary drainage in patients with hilar cholangiocarcinoma
R. Parks (2000)
10.1016/S1015-9584(08)60080-9
Pancreaticoduodenectomy with external drainage of the pancreatic remnant.
S. Sriussadaporn (2008)
10.1007/978-1-4939-2223-9_26
Postpancreatectomy Hemorrhage: Early and Late
Albert Amini (2015)
Pancreatogastroanastomosis modificada y preservación de píloro posterior a pancreatoduodenectomía. Reporte de un caso y revisión de la literatura
Kuauhyama ma Luna Ortiz (2000)
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