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 106
- Downloads 0
PANCREATOGASTROSTOMY WITH ONE CONTINUOUS SEROMUSCULAR CIRCULAR SUTURE
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), usi...
ROLE OF MALE GENDER IN LAPAROSCOPIC CHOLECYSTECTOMY OUTCOME
Laparoscopic cholecystectomy (LC) is one of the most commonly performed laparoscopic procedures. Problems occurring during laparoscopic cholecystectomy include bile duct injury, conversion to open operation, and other po...
CERVICAL ECTOPIC PREGNANCY WITH MASSIVE BLEEDING: A CASE REPORT
A 29-year-old patient with cervical ectopic pregnancy (CEP) presented as "suspected" cervical mass, and irregular vaginal bleeding was directed to a gynecologic oncologist for consultation. During the examination a massi...
TREATMENT OF IDIOPATHIC CHRONIC ORCHIALGIA WITH TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS): A PRELIMINARY RESULT
Purpose: Unilateral or bilateral testicular pain lasting more than three months is called as chronic orchialgia. Approximately 25-50% of chronic orchialgia is the idiopathic origin. This study aimed the effectiveness of...
BREAST DENSITY EVALUATION: A COMPARISON BETWEEN ASSESSMENT BY A RADIOLOGIST AND THE COMPUTER-ASSISTED THRESHOLD TECHNIQUE
Traditionally, mammographic density (MD) of the breast has been assessed by a radiologist visually. This subjective evaluation requires significant experience to distinguish the relative proportions of the fibrous connec...