Complications of Pancreatic Cancer Resection

Halloran, Christopher; Ghaneh, Paula; Bosonnet, L.; Hartley, Mark; Neoptolemos, John P.

doi:10.1159/000052029

Cited by 164 publications

(126 citation statements)

References 74 publications

(161 reference statements)

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“…The reported rates of PPH in literature is 5e12%. 17,18 The re-exploration rates was 7%, the most common reason being POPF (3/5 patients). The rates of re-exploration in the range of 4e11% have been reported in different series.…”

mentioning

confidence: 94%

Whipple's pancreaticoduodenectomy: Outcomes at a tertiary care hospital

Jakhmola

Kumar

2014

Medical Journal Armed Forces India

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MorbidityPostoperative pancreatic fistula Delayed gastric emptying Mortality Outcomes a b s t r a c t Background: Pancreaticoduodenectomy is a formidable surgery and was associated with high morbidity and mortality. Though the mortality rates have steadily improved, morbidity continues to be high. There is lack of published data on outcomes following pancreaticoduodenectomy in Armed Forces hospitals. The aim of this study was to analyze the short term outcomes at our center and to compare it with the published literature.Methods: A retrospective review of prospectively maintained data base was done. Preoperative, intraoperative and postoperative data was analyzed with emphasis on the morbidity and mortality rates. Follow up data was analyzed to look at disease recurrence.Results: Between Jan 2008 and March 2014, 69 patients underwent Whipple's pancreaticoduodenectomy with a median age of 64 years. All had a malignant etiology with periampullary carcinoma being the commonest (42%). Overall, intra-abdominal complications occurred in 46% of patients which included postoperative pancreatic fistula (20%) and delayed gastric emptying (24%). The mortality rate for the whole was 11% which reduced to 8% in the second half of the study. Conclusion:The short term outcomes at our center were comparable to those in published literature. The mortality rates showed a decreasing trend with time.

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mentioning

confidence: 94%

Whipple's pancreaticoduodenectomy: Outcomes at a tertiary care hospital

Jakhmola

Kumar

2014

Medical Journal Armed Forces India

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“…Although it has a reported incidence varying from 1% to 5-12% (6,15,18), postpancreatectomy intraluminal hemorrahge is considered a therapeutic challenge and presents standardized steps of its management. The associated outcome and mortality after early reoperation is at the moment still at high rates, with incidence fluctuating between 13-60% (23,24,25,26).…”

Section: Discussionmentioning

confidence: 99%

Intraluminal Postpancreatoduodenectomy Hemorrhage - Last 5 Years Experience

Valcea¹,

Beuran²,

Vartic³

2017

chr

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RezumatIntroducere: Hemoragia postoperatorie reprezintă una dintre cele mai semnificative complicaţii după duodenopancreatectomia cefalică. Scop: Studiul prezentat în acest articol analizează cazurile de hemoragie intralumenală de la nivelul anastomozei gastrojejunale mecanice secundară duodenopancreatectomiei cefalice. Material şi metodă: În perioada ianuarie 2012 -ianuarie 2017, 84 de rezecţii cefalo-pancreatice consecutive au fost efectuate de aceeaşi echipă chirurgicală. Procedeul preferat de reconstrucţie a fost Whipple (76 pacienţi). Anastomoza gastrojejunală a fost efectuată mecanic la toţi pacienţii, folosindu-se staplerul Panther liniar tip GIA. Clasificarea propusă de ISGPS a fost folosită pentru evaluarea severităţii hemoragiei. Rezultate: Din cei 84 de pacienţi, un număr de 7 cazuri de hemoragie intralumenală (8,33 %) a fost observat, în medie în ziua 4 postoperator. Relaparotomia a fost inevitabila în două cazuri. Trei pacienţi din subgrupul cu hemoragie intralumenală postpancreatectomie au decedat. În lotul studiat nu au fost înregistrate cazuri de hemoragie de la nivelul anastomozelor pancreatico-jejunală sau hepatico-jejunală. Concluzii: Anastomoza mecanică poate ridica controverse, sângerarea severă necesitând relaparotomie de urgenţă şi fiind corelată cu rate mari de mortalitate. Hemoragia intralumenală postduodenopancreatectomie rămâne o complicaţie importantă, al cărei management depinde de multipli factori şi care poate avea potenţial devastator.Cuvinte cheie: hemoragie, duodenopancreatectomie, management, mortalitate AbstractBackground: One of the most significant complications following pancreaticoduodenectomy is represented by postoperative hemorrhage. Aim: This study undertook an analysis of the cases that presented intraluminal bleeding of mechanical gastrojejunal anastomosis following pancreatico-

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“…Except for preventing perioperative bleeding in pancreatic cancer resections [87], there are no reports related to the use of octreotide/somatostatin in controlling bleeding in cancer patients.…”

Section: Somatostatin Analoguesmentioning

confidence: 99%

Management of Bleeding in Patients with Advanced Cancer

2004

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Bleeding occurs in up to 10% of patients with advanced cancer. It can present in many different ways. This article provides a qualitative review of treatment options available to manage visible bleeding. Local modalities, such as hemostatic agents and dressings, radiotherapy, endoscopic ligation and coagulation, and transcutaneous arterial embolization, are reviewed in the context of advanced cancer, as are systemic treatments such as vitamin K, vasopressin/desmopressin, octreotide/somatostatin, antifibrinolytic agents (tranexamic acid and aminocaproic acid), and blood products. Considerations at the end of life are described.

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Complications of Pancreatic Cancer Resection

Cited by 164 publications

References 74 publications

Whipple's pancreaticoduodenectomy: Outcomes at a tertiary care hospital

Whipple's pancreaticoduodenectomy: Outcomes at a tertiary care hospital

Intraluminal Postpancreatoduodenectomy Hemorrhage - Last 5 Years Experience

Management of Bleeding in Patients with Advanced Cancer

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