Abdaal W Khan1, Anil K Agarwal, Brian R Davidson. 1. University Department of Surgery, Royal Free Hospital Hampstead NHS Trust, Royal Free Campus, Royal Free and University College Medical School, London, UK.
Abstract
BACKGROUND: Over the last decade the operative mortality associated with pancreaticoduodenectomy (PD) has decreased. Pancreatic anastomotic leaks resulting in pancreatic bed sepsis and fistulae, however, remain a significant cause of both morbidity and mortality. The optimal method of reconstruction to minimise pancreatic leaks is controversial. AIM: To review the experience of Roux loop duct-to-mucosa pancreaticojejunostomy in a consecutive series of patients undergoing pancreatic head resection. METHODS: Over the 6-year period (1993-1998), 41 patients underwent pancreatic head resections for benign (n = 5) and malignant disease (n = 36). There were 19 males and the median age was 62 years (range 29-83). An isolated Roux loop pancreaticojejunostomy was performed in all cases. RESULTS: Median duration of surgery was 8 h and the median postoperative stay was 16 days. The mean peri-operative blood transfusion was 2.9 units (SD 1.9). The incidence of major complications was 12% and there was 1 death (2.4%). There were no pancreatic leaks or fistulae. CONCLUSIONS: The low complication rate and the absence of pancreatic fistulae in this series would suggest that Roux loop duct-to-mucosa pancreatic reconstruction should be more widely adopted. Copyright 2002 S. Karger AG, Basel
BACKGROUND: Over the last decade the operative mortality associated with pancreaticoduodenectomy (PD) has decreased. Pancreatic anastomotic leaks resulting in pancreatic bed sepsis and fistulae, however, remain a significant cause of both morbidity and mortality. The optimal method of reconstruction to minimise pancreatic leaks is controversial. AIM: To review the experience of Roux loop duct-to-mucosa pancreaticojejunostomy in a consecutive series of patients undergoing pancreatic head resection. METHODS: Over the 6-year period (1993-1998), 41 patients underwent pancreatic head resections for benign (n = 5) and malignant disease (n = 36). There were 19 males and the median age was 62 years (range 29-83). An isolated Roux loop pancreaticojejunostomy was performed in all cases. RESULTS: Median duration of surgery was 8 h and the median postoperative stay was 16 days. The mean peri-operative blood transfusion was 2.9 units (SD 1.9). The incidence of major complications was 12% and there was 1 death (2.4%). There were no pancreatic leaks or fistulae. CONCLUSIONS: The low complication rate and the absence of pancreatic fistulae in this series would suggest that Roux loop duct-to-mucosa pancreatic reconstruction should be more widely adopted. Copyright 2002 S. Karger AG, Basel
Authors: Faik G Uzunoglu; Matthias Reeh; Romy Wollstein; Nathaniel Melling; Daniel Perez; Yogesh K Vashist; Dean Bogoevski; Jakob R Izbicki; Maximilian Bockhorn Journal: World J Surg Date: 2014-12 Impact factor: 3.352
Authors: Ronnie T P Poon; Sheung Tat Fan; Chung Mau Lo; Kelvin K Ng; Wai Key Yuen; Chun Yeung; John Wong Journal: Ann Surg Date: 2007-09 Impact factor: 12.969