Novel Non-duct-to-Mucosa Pancreaticojejunostomy Reconstruction After Pancreaticoduodenectomy: Focus on the Occurrence of Post-pancreatectomy Hemorrhage and Intra-abdominal Abscess

Wu, Jin-Ming; Lin, Young-Jen; Wu, Ching-Feng; Kuo, Ting-Chun; Tien, Yu-Wen

doi:10.1245/s10434-023-13114-1

Cited by 4 publications

(2 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With advances in surgical techniques, perioperative supportive care, and nonsurgical treatment, the incidence of complications following pancreatic surgeries is gradually decreasing [21][22][23][24]. The most common complication after pancreatectomy is pancreatic stula, which represents the main source of morbidity.…”

Section: Discussionmentioning

confidence: 99%

Topical application of Glauber’s salt accelerates the absorption of abdominal fluid after pancreatectomy.

Li,

Hua,

Ruan

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Abdominal fluid collection (AFC) is one of the most common complications after pancreatic surgery, yet there are few recommendations on how to manage it. Most cases of AFC only require observation, while others may require more invasive techniques. Unfortunately, there are no drugs that effectively promote the absorption of AFCs. The aim of this study was to evaluate the potential efficacy of Glauber's salt solution for promoting the absorption of AFCs after pancreatectomy. Methods This study included 196 patients who underwent pancreatomy and had AFCs on at least 2 cross-sectional follow-up CT images between 2020 and 2022. AFCs were defined as effusion with a diameter ≥ 3 cm and located around the pancreatic resection margin. We retrospectively investigated the relationship between Glauber’s salt concentration and clinical variables. Results The rate of clinically significant pancreatic fistula (grades B + C) was significantly higher in the control group (62.8% vs. 40.7%, P = 0.014). The median maximum diameter of the AFC was smaller, and the median time for the AFC to decrease to 30 mm in diameter was shorter in the Glauber’s salt group than in the control group (41.9 mm vs. 53.5 mm, P = 0.008; 35.5 d vs. 100 d, P < 0.001). According to the multivariate analysis, percutaneous drainage and the application of Glauber’s salt were found to be independent risk factors for AFCs decreasing to less than 30 mm in diameter (HR = 2.338, 95% CI = 1.524–3.585, P < 0.001; HR = 1.853, 95% CI = 1.327–2.589, P < 0.001). Additionally, patients with a maximum postoperative temperature exceeding 38.5°C exhibited enhanced AFC absorption (hazard ratio (HR) = 1.850, 95% CI = 1.268–2.701; P = 0.001). Conclusions Topical application of Glauber's salt solution after pancreatic surgery can promote the absorption of AFCs.

show abstract

Section: Discussionmentioning

confidence: 99%

Topical application of Glauber’s salt accelerates the absorption of abdominal fluid after pancreatectomy.

Li,

Hua,

Ruan

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In contrast, pancreatic metastasis and serous cystic neoplasm (SCN), a neuroendocrine neoplasm, increase the risk of POPF due to a soft pancreas and small pancreatic ducts [30]. Several surgical pancreaticojejunostomy/pancreaticogastrostomy techniques following PD, as well as pancreatic stump creation or pancreatic transection, have been introduced to reduce the risk of POPF [25,[34][35][36][37].…”

mentioning

confidence: 99%

Pancreatectomy and Pancreatic Surgery

Jabłońska

Mrowiec

2023

Life

View full text Add to dashboard Cite

Pancreatectomy, including pancreaticoduodenectomy (PD), as well as central pancreatectomy (CP), distal pancreatectomy (DP) and total/subtotal pancreatectomy, is a major, complex and difficult surgical procedure performed for various benign and malignant pancreatic diseases: from chronic pancreatitis, through benign cystic tumors and neuroendocrine neoplasms to malignant neoplasms, including pancreatic ductal adenocarcinoma (PDAC) [...]

show abstract

Most total pancreatectomies for ductal adenocarcinoma potentially can be replaced by Whipple over the splenic artery: a before and after study

Kuo,

Wu,

Chen

et al. 2024

International Journal of Surgery

View full text Add to dashboard Cite

Introduction: Recently, more and more total pancreatectomy (TP) has been performed for central-located pancreatic ductal cell adenocarcinoma (PDCA) which abuts or involves both gastroduodenal and splenic arteries and demands transaction of both of them for a complete resection. Spiked by Warshaw’s procedure (spleen-preserving distal pancreatectomy with excision of splenic vessels), we developed a new procedure “Whipple over the splenic artery (WOTSA)” to replace TP by leftward extension of pancreatic parenchyma transaction line and preservation of pancreatic tail and spleen after excision of splenic artery. This uncontrolled before and after study assesses the safety and efficacy of a new technique “Whipple over the splenic artery (WOTSA)” as a treatment for PDAC which traditionally requires total pancreatectomy (TP) for a complete excision. Methods: The study group comprised 40 consecutive patients who underwent WOTSA for PDAC between August 2019 and September 2022. Their clinicopathological characteristics and survival were compared with those of a historical control group comprising 30 consecutive patients who underwent TP between January 2016 and July 2019. Results: None of the 40 patients in the WOTSA group required reoperation due to infarction of the pancreas and/or spleen remnant. DM medication after WOTSA were none in 19, oral hypoglycemic agents in 19, and insulin preparations in 2 patients. Compared with TP, patients who underwent WOTSA exhibited similar rates of major operative complications, clear pancreatic parenchyma transaction margin, and number of harvested positive lymph nodes, but higher rate of adjuvant chemotherapy completion and a trend toward better median disease free survival (14 vs. 7.5 mo, P=0.023). Conclusions: Compared to TP, WOTSA can be safely performed and have much better postoperative glycemic status without cost of higher operative risk or impaired surgical radicality. These findings indicate that most TPs for PDAC potentially can be replaced by WOTSAs.

show abstract

Novel Non-duct-to-Mucosa Pancreaticojejunostomy Reconstruction After Pancreaticoduodenectomy: Focus on the Occurrence of Post-pancreatectomy Hemorrhage and Intra-abdominal Abscess

Cited by 4 publications

References 40 publications

Topical application of Glauber’s salt accelerates the absorption of abdominal fluid after pancreatectomy.

Topical application of Glauber’s salt accelerates the absorption of abdominal fluid after pancreatectomy.

Pancreatectomy and Pancreatic Surgery

Most total pancreatectomies for ductal adenocarcinoma potentially can be replaced by Whipple over the splenic artery: a before and after study

Contact Info

Product

Resources

About