Different methods of the gastrointestinal tract reconstruction after pancreaticoduodenectomy – is this procedure optimal?
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 1
Abstract
Pancreaticoduodenectomy is one of the most complexed surgical procedures. It is also extremely challenging for the surgeon who performs it. Due to the decreasing mortality rate and the reduction of the postoperative complications during the early postoperative period these surgical procedures have been performed more often in the last few years. The proper decission concerning the method of the anastomoses performed within the area of the gastrointestinal tract during the second-reconstructive-stage is highly important in order to restore the pancreatic enzymes secretory functions (similar to the physiological conditions), as well as the motor activity of the gastrointestinal tract in the distant postoperative period.The surgeon must choose between the classical pancreaticojejunostomy and the pancreaticogastrostomy which is nowadays performed more frequently. The following article presents current scientific knowledge which compares these two types of anastomoses based on literature including the metaanalysis, radomized controlled trials in addition to other reports which take into consideration both the early postoperative period (the pancreatic fistula and other postoperative complications) as well as late pancreaticoduodenectomy consequences. Based on the quoted works one cannot give an unambiguous answer to the question about which type of pancreatic stump anastomosis is more favourable to the patient. Due to this fact a further analysis is needed.
Authors and Affiliations
Sławomir Mrowiec, Katarzyna Kuśnierz, Paweł Musialski
Keywords
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