PANCREATOGASTROSTOMY WITH ONE CONTINUOUS SEROMUSCULAR CIRCULAR SUTURE
Journal Title: International Journal of Surgery and Medicine - Year 2015, Vol 1, Issue 1
Abstract
Objective One of the most feared complications after pancreaticoduodenectomy (PD) remains postoperative pancreatic fistula (POPF). In the current study, we demonstrate a new technique for pancreaticogastrostomy (PG), using one continuous seromuscular circular suture without trans pancreas sutures for PG. Material and Methods During the period December 2012 to December 2014, 32 consecutive patients underwent PD (either pylorus-preserving or classical Whipple’s) carried out using the above suture-less PG. Indication for PD was pancreatic duct carcinoma. Procedures were carried out by the same surgeon, same approach and anastomotic method in order to avoid technical changes. Results Postoperative mortality was zero and morbidity was 21.8% (n=7). Pancreatic leakage (Grade A/B) occurred in 2 (6.2%) patients. These pancreatic leaks were managed nonoperative by maintaining the closed drains. The most common postoperative complication delayed gastric emptying (Grade B/C) in 3 (9.3%) patients. Conclusion We conclude that the suture-less PG possesses several advantages over conventional PG and pancreaticojejunostomy (PJ). This technic seems to lessen the risk of a pancreatic leak, probably by diminishing the possibility of suture damage to the pancreas and by embedding the transected stump into the posterior gastric wall. This novel PG is a valid and valuable procedure, especially for soft, nonfibrotic pancreas.
Authors and Affiliations
Daniel Kostov Kostov, Georgi Kobakov, Daniel Yankov
Keywords
Related Articles
- EP ID EP216448
- DOI 10.5455/ijsm.20150411090731
- Views 101
- Downloads 0
CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS
Background: Axillary lymph node status is the most important breast cancer prognostic factor. Preoperative axillary ultrasound examination (PAUS) is used to triage patients for sentinel lymph node biopsy (SLNB) or axilla...
TREATMENT OF RENAL STONES WITH PERCUTANEOUS NEPHROLITHOTOMY IMPROVES RENAL FUNCTIONS IN CHRONIC KIDNEY DISEASE PATIENTS
In this study, we aimed to investigate the impact of percutaneous nephrolithotomy on kidney functions in stage III or higher chronic renal failure patients using glomerular filtration rate and serum creatinine level. Me...
WATCH AND WAIT APPROACH IN RECTAL CANCER TREATMENT
Introduction: The colorectal carcinoma is the most common gastrointestinal neoplasm worldwide and in Bulgaria. Often the choice of surgical treatment is difficult, and organ-preserving surgery is not feasible. In borderl...
GIANT GLUTEAL LIPOMA: A CASE REPORT AND REVIEW OF LITERATURE
Introduction : Lipoma is one of the most common benign mesenchymal tumor which can occur in almost in all organs of the body where fat normally exists, so called as universal tumor or ubiquitous tumor. Lipomas are slow g...
INTERVENTION OR SURVEILLANCE? CURRENT EVIDENCE IN VISCERAL ARTERY ANEURYSMS
Visceral artery aneurysms (VAAs) are an increasingly encountered clinical problem. Although their incidence is low at about 0.2% in the general population, they are increasingly found on cross-sectional imaging. Therefor...