Academic Journal

Selective use of pancreatic duct occlusion during pancreaticoduodenectomy in patients with a small-size duct and atrophic parenchyma in the distal pancreas: A retrospective study

التفاصيل البيبلوغرافية
العنوان: Selective use of pancreatic duct occlusion during pancreaticoduodenectomy in patients with a small-size duct and atrophic parenchyma in the distal pancreas: A retrospective study
المؤلفون: Guangbin Chen, Jie Yin, Qun Chen, Jishu Wei, Kai Zhang, Lingdong Meng, Yichao Lu, Pengfei Wu, Baobao Cai, Zipeng Lu, Yi Miao, Kuirong Jiang
المصدر: Frontiers in Surgery, Vol 9 (2023)
بيانات النشر: Frontiers Media S.A., 2023.
سنة النشر: 2023
المجموعة: LCC:Surgery
مصطلحات موضوعية: pancreaticoduodenectomy, pancreatic duct occlusion, pancreatic fistula, pancreatic atrophy, pancreas, Surgery, RD1-811
الوصف: BackgroundDespite the advancements in surgical techniques, postoperative pancreatic fistula (POPF) remains a potentially life-threatening complication of pancreaticoduodenectomy (PD). Pancreatic duct occlusion (PDO) without anastomosis has also been proposed to alleviate the clinical consequences of POPF in selected patients after PD.ObjectivesTo assess the safety and effectiveness of PDO with mechanical closure after PD in patients with an atrophic pancreatic body-tail and a small pancreatic duct.MethodsWe retrospectively identified two female and two male patients from April 2019 to October 2020 through preoperative computed tomography of the abdomen. Among them, three patients underwent PDO with mechanical closure after PD, and one underwent PDO after pylorus-preserving PD. In addition, patients' medical records and medium-and long-term follow-up data were analyzed.ResultsPostoperative histological examination revealed a solid pseudopapillary tumor in two patients, pancreatic ductal adenocarcinoma in one patient, and chronic pancreatitis with pancreatic duct stones in one patient. However, none of the patients developed biochemical or clinically relevant POPF, with no postpancreatectomy hemorrhage, biliary leakage, delayed gastric emptying, intra-abdominal abscess, or chyle leakage. Among the four patients, three developed new-onset diabetes mellitus, and one had impaired glucose tolerance. Furthermore, three patients received pancreatic enzyme supplementation at a dose of 90,000 Ph. Eur. units/d, and one was prescribed a higher dose of 120,000 Ph. Eur. units/d.ConclusionsPDO with mechanical closure is an alternative approach for patients with an atrophic pancreatic body-tail and a small pancreatic duct after PD. Therefore, further evidence should evaluate the potential benefits of selective PDO in these patients.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2296-875X
Relation: https://www.frontiersin.org/articles/10.3389/fsurg.2022.968897/full; https://doaj.org/toc/2296-875X
DOI: 10.3389/fsurg.2022.968897
URL الوصول: https://doaj.org/article/2dc8685caf8a4d82b197ad62157f9c24
رقم الانضمام: edsdoj.2dc8685caf8a4d82b197ad62157f9c24
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:2296875X
DOI:10.3389/fsurg.2022.968897