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Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique
INTRODUCTION: Intra-abdominal hemorrhage following pancreatic fistula is a fatal complication after pancreatico-duodenectomy. Intra-abdominal hemorrhage has reportedly decreased with the use of fibrin glue or polyglycolic acid felt and wrapping of the skeletonized vessels by omentum or falciform lig...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765080/ https://www.ncbi.nlm.nih.gov/pubmed/23945081 http://dx.doi.org/10.1186/1752-1947-7-209 |
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author | Usuba, Teruyuki Iino, Toshio Hanyu, Nobuyoshi |
author_facet | Usuba, Teruyuki Iino, Toshio Hanyu, Nobuyoshi |
author_sort | Usuba, Teruyuki |
collection | PubMed |
description | INTRODUCTION: Intra-abdominal hemorrhage following pancreatic fistula is a fatal complication after pancreatico-duodenectomy. Intra-abdominal hemorrhage has reportedly decreased with the use of fibrin glue or polyglycolic acid felt and wrapping of the skeletonized vessels by omentum or falciform ligament. However, there are no extremely effective methods for the prevention of hemorrhage. Here, we report our novel and simple method for the prevention of intra-abdominal hemorrhage due to pancreatic fistula. METHODS: The anastomotic site of the pancreato-jejunostomy in pancreatico-duodenectomy is displaced from the superior to inferior side of the transverse mesocolon through a small window created on the left side of the middle colic artery of the transverse mesocolon. This procedure is expected to prevent exposure of the skeletonized vessels to activated pancreatic juice from a pancreatic fistula after lymph node dissection, decreasing the incidence of hemorrhage. Two drains are placed on the superior and inferior sides of the transverse mesocolon. We performed this procedure in seven patients and compared the amylase level in the drainage fluid from the superior and inferior sides. RESULTS: There was no difference in the fluid amylase level from the drains between the superior and inferior sides, because a pancreatic fistula was not present in all our patients. Therefore, we could not evaluate the efficacy of this method in the current study. CONCLUSIONS: Our procedure is theoretically expected to prevent intra-abdominal hemorrhage and will be an option in pancreatico-duodenectomy, especially for patients with a soft pancreas. However, it is necessary to evaluate the performance and results of this procedure in many more patients. |
format | Online Article Text |
id | pubmed-3765080 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-37650802013-09-07 Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique Usuba, Teruyuki Iino, Toshio Hanyu, Nobuyoshi J Med Case Rep Research Article INTRODUCTION: Intra-abdominal hemorrhage following pancreatic fistula is a fatal complication after pancreatico-duodenectomy. Intra-abdominal hemorrhage has reportedly decreased with the use of fibrin glue or polyglycolic acid felt and wrapping of the skeletonized vessels by omentum or falciform ligament. However, there are no extremely effective methods for the prevention of hemorrhage. Here, we report our novel and simple method for the prevention of intra-abdominal hemorrhage due to pancreatic fistula. METHODS: The anastomotic site of the pancreato-jejunostomy in pancreatico-duodenectomy is displaced from the superior to inferior side of the transverse mesocolon through a small window created on the left side of the middle colic artery of the transverse mesocolon. This procedure is expected to prevent exposure of the skeletonized vessels to activated pancreatic juice from a pancreatic fistula after lymph node dissection, decreasing the incidence of hemorrhage. Two drains are placed on the superior and inferior sides of the transverse mesocolon. We performed this procedure in seven patients and compared the amylase level in the drainage fluid from the superior and inferior sides. RESULTS: There was no difference in the fluid amylase level from the drains between the superior and inferior sides, because a pancreatic fistula was not present in all our patients. Therefore, we could not evaluate the efficacy of this method in the current study. CONCLUSIONS: Our procedure is theoretically expected to prevent intra-abdominal hemorrhage and will be an option in pancreatico-duodenectomy, especially for patients with a soft pancreas. However, it is necessary to evaluate the performance and results of this procedure in many more patients. BioMed Central 2013-08-14 /pmc/articles/PMC3765080/ /pubmed/23945081 http://dx.doi.org/10.1186/1752-1947-7-209 Text en Copyright © 2013 Usuba et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Usuba, Teruyuki Iino, Toshio Hanyu, Nobuyoshi Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique |
title | Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique |
title_full | Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique |
title_fullStr | Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique |
title_full_unstemmed | Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique |
title_short | Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique |
title_sort | relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765080/ https://www.ncbi.nlm.nih.gov/pubmed/23945081 http://dx.doi.org/10.1186/1752-1947-7-209 |
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