Pancreatic stump preparation by pancreatoduodenal resection
Alibegov, R.A.; Narezkin, D.V.; Sergeev, O.A.; Prokhorenko, T.I.; Zhvitiashvili, I.D.
Khirurgiia 2009(9): 41-45
2009
ISSN/ISBN: 0023-1207 PMID: 19770822 Document Number: 630728
Short-term results of 124 pancreatoduodenal resections (PDR) are analyzed. 65,3% of patients had pancreatic cancer, 12,1% - cancer of the papilla Vateri, 3,2% - cancer of the terminal part of the common bile duct, 2,4% - cancer of the duodenum, 2,4% carcinoid of the pancreas, 14,5% - chronic pancreatitis with the affection og the head. Standard Whipple procedure performed in 91 patients, pyloro-saving PDR - in 32 cases and total pancreatoduodenectomy in one patient. 3 types of pancreatic stump preparation were used. Pancreatojejunal anastomosis (PEA) (n=63) considered to be the first, pancreatogastroanastomosis (PGA) (n=46 ) - the second and external pancreaticostomy (n=15) - the third. Overall anastomosis failure rate was 12,1% (n=15). By PEA, failure rate was 27,5% and was noticed predominately in cases of connecting all area of pancreatic slice with the gut (43,5%). PGA failure rate was 2,1% (n=1). Therefore, PDA should be considered to be a reliable pancreatodigestive anastomosis, allowing a decrease of postoperative complication rate to 26,1% and lethality rate to 2,1%.