Pancreaticoduodenectomy with External Drainage of the Pancreatic Remnant

Sriussadaporn, Suvit; Pak‐art, Rattaplee; Sriussadaporn, Sukanya; Kritayakirana, Kritaya; Prichayudh, Supparerk

doi:10.1016/s1015-9584(08)60080-9

Cited by 23 publications

(23 citation statements)

References 23 publications

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“…Finally, 6 articles were identified for inclusion: 3 prospective RCTs [17,18,27], and 3 OCSs [15,28,29]. The 2 reviewers had 100% agreement in their reviews of the data extraction.…”

Section: Resultsmentioning

confidence: 99%

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Does External Pancreatic Duct Stent Decrease Pancreatic Fistula Rate after Pancreatic Resection? A Meta-Analysis

et al. 2011

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“…Finally, 6 articles were identified for inclusion: 3 prospective RCTs [17,18,27], and 3 OCSs [15,28,29]. The 2 reviewers had 100% agreement in their reviews of the data extraction.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies were conducted in Japan [18,29]; 1 in Germany [15]; 1 in Hong Kong [17]; 1 in France [27], and 1 in Thailand [28]. The sample size of each study varied from 45 to 158 patients.…”

Section: Resultsmentioning

confidence: 99%

Does External Pancreatic Duct Stent Decrease Pancreatic Fistula Rate after Pancreatic Resection? A Meta-Analysis

et al. 2011

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“…We had demonstrated in our previous reports of pancreaticoduodenectomy, that meticulous surgical techniques were important when performing these complex surgical procedures. Furthermore, external drainage of the pancreatic remnant, with an external pancreatic stent, may help lessen the occurrence of a postoperative pancreatic fistula [18,24,25]. When performing a distal pancreatectomy, the main pancreatic duct at the pancreatic stump must be identified and ligated to prevent a postoperative pancreatic fistula.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatments of cystic neoplasms of the pancreas: an Asian university hospital experience

Sriussadaporn

Pak‐art

et al. 2015

Asian Biomedicine

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Background: Premalignant and malignant cystic neoplasms of the pancreas are relatively rare, but absolute indications for surgical resection. Modern imaging modalities have increased recognition of asymptomatic cysts resulting in therapeutic dilemmas of whether surgery or observation is appropriate. Objectives: To examine our surgical experience with cystic neoplasms of the pancreas. Methods: A retrospective study of patients who had cystic neoplasms of the pancreas and underwent surgical resections from June 2000 to April 2013. Presenting symptoms, surgical procedures, pathological diagnoses, and postoperative complications were analyzed. Results: Data from 16 patients were examined. Two patients had asymptomatic cystic neoplasms. Fourteen had symptoms ranging from 2 days to 6 years before diagnosis and surgery. Six patients underwent pylorus preserving pancreaticoduodenectomy, 4 underwent distal pancreatectomy with splenectomy, 2 underwent splenic preserving distal pancreatectomy, and 1 each underwent a classical Whipple operation, total pancreatectomy, distal pancreatectomy with splenectomy with partial resection of the posterior gastric wall, and distal pancreatectomy with splenectomy with left colectomy. The operative time ranged from 150 to 450 minutes. Operative blood transfusion ranged from 0 to 5 units. Four patients had mucinous cystadenoma, 4 had intraductal papillary mucinous neoplasia with varying degree of dysplasia and carcinomatous changes, 6 had other malignancies, and 2 had other benign cysts. Postoperative complications occurred in 3 patients. There was no perioperative mortality. Conclusion: Any suspicion of malignant changes in asymptomatic cysts should have them considered for surgical resection. Meticulous surgical techniques are important for pancreatic resection to minimize the occurrence of postoperative complications.

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“…Several surgical methods of constructing a gastrojejunal anastomosis have been advocated, none of which can completely eliminate the possibility of leakage (1). Current data on the endoscopic management of anastomotic leakage are also limited, with some reports on the successful use of fibrin adhesives and endoscopic vacuum-assisted closure encountered in the literature (5,6).…”

Section: Successful Endoscopic Management Of Anastomotic Dehiscence Wmentioning

confidence: 99%

“…Among a long list of complications currently recognized after pancreaticoduodenectomy, anastomotic leakage is a serious one, with an incidence of 8-20% in recent studies (1). Although the majority of patients with anastomotic leakage can be successfully treated by conservative means, serious consequences such as bleeding and severe intra-abdominal infection may occur (2,3).…”

mentioning

confidence: 99%

Successful endoscopic management of anastomotic dehiscence with hemoclips application after pancreaticoduodenectomy

İbi̇ş¹,

Beyazıt²,

Turokoğlu³

et al. 2012

Turk J Gastroenterol

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A 57-year-old woman who had undergone a pancreaticoduodenectomy operation two weeks previously for distal cholangiocellular carcinoma was referred to our department due to prolonged and excessive drainage (>500 ml/day) from her surgical drain. Initial examination of the patient revealed no signs of peritonitis or sepsis. Endoscopic examination revealed a suture dehiscence over almost half of the complete circumference of the gastrojejunal anastomosis ( Figure 1A). Following irrigation of the suture line for better visualization, the opposing wound lips were traumatized by forceps to facilitate the re-epithelization process. Afterwards, complete repair was achieved using a total of 11 hemoclips that were carefully applied along the anastomosis ( Figure 1B). Anastomotic leakage began to reduce after the endoscopic procedure and ceased after the third day of hemoclip application. A follow-up endoscopy two months later showed an intact anastomosis line with no signs of leakage (Figure 2).Among a long list of complications currently recognized after pancreaticoduodenectomy, anastomotic leakage is a serious one, with an incidence of 8-20% in recent studies (1). Although the majority of patients with anastomotic leakage can be successfully treated by conservative means, serious consequences such as bleeding and severe intra-abdominal infection may occur (2,3). Moreover, delayed gastric emptying, re-laparotomy, prolonged hospitalization, and added costs are also unwanted related sequelae. Conventional management of clini- Successful endoscopic management of anastomotic dehiscence with hemoclips application after pancreaticoduodenectomyPankreatikoduodenektomi sonras› geliflen anastomoz kaça¤›n›n hemoklips uygulamas› ile tedavisi Manuscript

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Pancreaticoduodenectomy with External Drainage of the Pancreatic Remnant

Abstract: External drainage of the pancreatic remnant after pancreaticoduodenectomy is an effective method for prevention of pancreaticojejunal anastomosis leakage and other related complications.

Cited by 23 publications

References 23 publications

Does External Pancreatic Duct Stent Decrease Pancreatic Fistula Rate after Pancreatic Resection? A Meta-Analysis

Does External Pancreatic Duct Stent Decrease Pancreatic Fistula Rate after Pancreatic Resection? A Meta-Analysis

Surgical treatments of cystic neoplasms of the pancreas: an Asian university hospital experience

Successful endoscopic management of anastomotic dehiscence with hemoclips application after pancreaticoduodenectomy

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