INTRODUCTION: Management of pancreatic leak and haemorrhage is complex with high mortality rates. In this study, the results of completion pancreatectomy which was performed as a last resort option were analysed. PATIENTS AND METHODS: 25 patients who had completion pancreatectomy from among 677 patients who had pancreatoduodenectomy or distal pancreatectomy over a period of 18 years were analysed in terms of the indications for completion pancreatectomy, outcome and survival data. RESULTS: Indications for completion pancreatectomy include pancreatic leak in 12 patients (48%), both bleeding and pancreatic leak in 8 (32%), and haemorrhage alone in 5 (20%) patients. 18 (72%) patients also had splenectomy. Median ITU stay was 4 and 8 days for those who survived and died post-completion pancreatectomy, respectively. 36% patients had septicaemia and 32% patients had multiple organ failure. 12 patients survived the operation with a median survival of 52 months. CONCLUSION: 25 (3.6%) patients required surgical intervention for pancreatic complications. The incidence of splenectomy was 84.6% in those who died after completion pancreatectomy compared to 58.3% of those who survived (Fisher's exact test two-sided 0.20). Despite significant morbidity and mortality, completion pancreatectomy has a role in the management of post-pancreatic surgical complications. Copyright (c) 2006 S. Karger AG, Basel.
INTRODUCTION: Management of pancreatic leak and haemorrhage is complex with high mortality rates. In this study, the results of completion pancreatectomy which was performed as a last resort option were analysed. PATIENTS AND METHODS: 25 patients who had completion pancreatectomy from among 677 patients who had pancreatoduodenectomy or distal pancreatectomy over a period of 18 years were analysed in terms of the indications for completion pancreatectomy, outcome and survival data. RESULTS: Indications for completion pancreatectomy include pancreatic leak in 12 patients (48%), both bleeding and pancreatic leak in 8 (32%), and haemorrhage alone in 5 (20%) patients. 18 (72%) patients also had splenectomy. Median ITU stay was 4 and 8 days for those who survived and died post-completion pancreatectomy, respectively. 36% patients had septicaemia and 32% patients had multiple organ failure. 12 patients survived the operation with a median survival of 52 months. CONCLUSION: 25 (3.6%) patients required surgical intervention for pancreatic complications. The incidence of splenectomy was 84.6% in those who died after completion pancreatectomy compared to 58.3% of those who survived (Fisher's exact test two-sided 0.20). Despite significant morbidity and mortality, completion pancreatectomy has a role in the management of post-pancreatic surgical complications. Copyright (c) 2006 S. Karger AG, Basel.
Authors: F Jasmijn Smits; Hjalmar C van Santvoort; Marc G Besselink; Marilot C T Batenburg; Robbert A E Slooff; Djamila Boerma; Olivier R Busch; Peter P L O Coene; Ronald M van Dam; David P J van Dijk; Casper H J van Eijck; Sebastiaan Festen; Erwin van der Harst; Ignace H J T de Hingh; Koert P de Jong; Johanna A M G Tol; Inne H M Borel Rinkes; I Quintus Molenaar Journal: JAMA Surg Date: 2017-06-01 Impact factor: 14.766
Authors: Michael F Nentwich; Alexander T El Gammal; Torben Lemcke; Tarik Ghadban; Eugen Bellon; Nathaniel Melling; Kai Bachmann; Matthias Reeh; Faik G Uzunoglu; Jakob R Izbicki; Maximilian Bockhorn Journal: World J Surg Date: 2015-06 Impact factor: 3.352