Online citations, reference lists, and bibliographies.

Extended Pancreatic Transection For Secure Pancreatic Reconstruction During Pancreaticoduodenectomy

Eun-Kyoung Jwa, Shin Hwang
Published 2017 · Medicine
Cite This
Download PDF
Analyze on Scholarcy
Backgrounds/Aims Pancreaticoduodenectomy (PD) is associated with various surgical complications including healing failure of the pancreaticojejunostomy (PJ). This study intended to ensure blood supply to the pancreatic stump through extended pancreatic transection (EPT). Methods This study assessed whether EPT reduces PJ-associated complications and whether EPT is harmful on the remnant pancreatic function. The EPT group included 19 patients undergoing PD, pylorus-preserving PD (PPPD) or hepatopancreaticoduodenectomy. The propensity score matched control group included 45 patients who had undergone PPPD. Pancreatic transection was performed at the level of the celiac axis in the EPT group, by which the pancreatic body was additionally removed by 3 cm in length comparing with the conventional pancreatic transection. Results A small invagination fissure suspected as the embryonic fusion site was identified at the ventro-caudal edge of the pancreatic body in all patients undergoing EPT. A sizable fissure permitting easy separation of the pancreatic parenchyma was identified in 15 of 19 patients (78.9%). The incidence of significant postoperative pancreatic fistula was significantly lower in the EPT group than in the control group (p=0.047). There was no significant increase in the postoperative de novo diabetes mellitus in EPT group (p=0.60). Conclusions The EPT technique contributes to the prevention of major pancreatic fistula without impairing remnant pancreatic function. EPT is feasible for routine clinical application or at least in patients with any known risk of PJ leak.
This paper references
Diagnosis of postoperative pancreatic fistula.
Olivier Facy (2012)
The Complications of Pancreatectomy
Michael Trede (1988)
[An analysis on the amount of excreted pancreatic juice after pancreatoduodenectomy].
Dong Hwan Jung (2004)
Evolution and current status of the Whipple procedure: an update for gastroenterologists.
Steven M. Strasberg (1997)
Systematic review and meta-analysis of outcomes after intraoperative pancreatic duct stent placement during pancreaticoduodenectomy.
J J Xiong (2012)
Incidence, risk factors and clinical implications of chyle leak after pancreatic surgery
Oliver Strobel (2017)
Postoperative pancreatic fistula: an international study group (ISGPF) definition.
C. Bassi (2005)
Pancreatic Anastomotic Leakage after Pancreaticoduodenectomy. Risk factors, Clinical predictors, and Management (Single Center Experience)
Ayman El Nakeeb (2013)
Current management of pancreatic fistula after pancreaticoduodenectomy.
G. Aranha (2006)
Risk factors and outcomes of postoperative pancreatic fistula after pancreatico-duodenectomy: an audit of 532 consecutive cases
Shun-jun Fu (2015)
간담췌외과 수술시 흡인형 Cigarette 배액관의 임상 적용
황신 (2004)
Management of Complications Following Pancreaticoduodenectom
C. Yeo (1995)
Extended pancreatic transection
G Godlewski (2011)
Prediction of Anastomotic Leak and its Prognosis in Digestive Surgery
Y. Haga (2010)
Moving and fusion of the pancreatic buds in the rat embryos during the embryonic period (carnegie stages 13–17) by a three-dimensional computer-assisted reconstruction
Guilhem Godlewski (2011)
Does Resident Experience Affect Outcomes in Complex Abdominal Surgery? Pancreaticoduodenectomy as an Example
Daniel M. Relles (2013)
Complications following pancreaticoduodenectomy
BW Miedema (1992)
Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: results of a prospective randomized trial.
C. Bassi (2003)
Defining Treatment and Outcomes of Hepaticojejunostomy Failure Following Pancreaticoduodenectomy
Richard A. Burkhart (2012)
Pancreatic Atrophy Relative to External Versus Internal Drainage of the Pancreatic Duct After Pylorus-Preserving Pancreaticoduodenectomy
Daegwang Yoo (2014)
Clinical application of sution-type cigarette drain for hepatopancreatoabiliary surgery
S Hwang (2004)
Management of complications following pancreaticoduodenectomy.
Charles J Yeo (1995)
Barrier function of the coelomic epithelium in the developing pancreas
Ping Guo (2014)
Complications following pancreaticoduodenectomy. Current management.
B. Miedema (1992)

Semantic Scholar Logo Some data provided by SemanticScholar