Pancreatoduodenectomy for trauma: applying novel reconstruction techniques
This single center study evaluated the technical modifications and outcome of reconstruction after pancreaticoduodenectomy for trauma. Prospectively recorded data including reconstructive techniques used in patients who underwent a pancreatoduodenectomy (PD) for trauma were analyzed. Twenty patients...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2016-06-01
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| Series: | Surgical Techniques Development |
| Subjects: | |
| Online Access: | http://www.pagepress.org/journals/index.php/std/article/view/6293 |
| _version_ | 1797368633734725632 |
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| author | Jake E.J. Krige Sandie R. Thomson |
| author_facet | Jake E.J. Krige Sandie R. Thomson |
| author_sort | Jake E.J. Krige |
| collection | DOAJ |
| description | This single center study evaluated the technical modifications and outcome of reconstruction after pancreaticoduodenectomy for trauma. Prospectively recorded data including reconstructive techniques used in patients who underwent a pancreatoduodenectomy (PD) for trauma were analyzed. Twenty patients underwent a PD. Six had an initial damage control procedure. Thirteen had a pylorus-preserving PD and 7 a standard Whipple resection because injury to the pylorus precluded a pylorus-preserving resection. Twelve patients had a pancreatojejunostomy and 8 a pancreatogastrostomy, 3 of whom had a duodenojejunal hepaticojejunal sequence of anastomoses to allow endoscopic biliary stent retrieval. Three patients died postoperatively of multi-organ failure. All 17 survivors had postoperative complications: 5 patients developed pancreatic fistula, 2 had gastric outlet obstruction, 2 had bile leaks, 2 had duodenal anastomotic leaks, all of which resolved with conservative treatment. Pancreatic and biliary reconstructions performed under adverse conditions after a trauma PD required a variety of technical modifications. The pylorus does not have to be sacrificed and posterior gastric implantation is a safe option for an edematous pancreas. |
| first_indexed | 2024-03-08T17:35:34Z |
| format | Article |
| id | doaj.art-12d3b71a7734421f83b408621f0be0e7 |
| institution | Directory Open Access Journal |
| issn | 2038-9574 2038-9582 |
| language | English |
| last_indexed | 2024-03-08T17:35:34Z |
| publishDate | 2016-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgical Techniques Development |
| spelling | doaj.art-12d3b71a7734421f83b408621f0be0e72024-01-02T12:14:50ZengMDPI AGSurgical Techniques Development2038-95742038-95822016-06-016110.4081/std.2016.62933375Pancreatoduodenectomy for trauma: applying novel reconstruction techniquesJake E.J. Krige0Sandie R. Thomson1Surgical Gastroenterology Unit; Hepatobiliary and Pancreatic Surgical Unit, Groote Schuur Hospital, Cape Town; Department of Surgery, University of Cape Town Health Sciences Faculty, Cape TownMedical Gastroenterology Unit, Groote Schuur Hospital, Cape Town; Department of Medicine, University of Cape Town Health Sciences Faculty, Cape TownThis single center study evaluated the technical modifications and outcome of reconstruction after pancreaticoduodenectomy for trauma. Prospectively recorded data including reconstructive techniques used in patients who underwent a pancreatoduodenectomy (PD) for trauma were analyzed. Twenty patients underwent a PD. Six had an initial damage control procedure. Thirteen had a pylorus-preserving PD and 7 a standard Whipple resection because injury to the pylorus precluded a pylorus-preserving resection. Twelve patients had a pancreatojejunostomy and 8 a pancreatogastrostomy, 3 of whom had a duodenojejunal hepaticojejunal sequence of anastomoses to allow endoscopic biliary stent retrieval. Three patients died postoperatively of multi-organ failure. All 17 survivors had postoperative complications: 5 patients developed pancreatic fistula, 2 had gastric outlet obstruction, 2 had bile leaks, 2 had duodenal anastomotic leaks, all of which resolved with conservative treatment. Pancreatic and biliary reconstructions performed under adverse conditions after a trauma PD required a variety of technical modifications. The pylorus does not have to be sacrificed and posterior gastric implantation is a safe option for an edematous pancreas.http://www.pagepress.org/journals/index.php/std/article/view/6293PancreatoduodenectomyTraumaReconstruction |
| spellingShingle | Jake E.J. Krige Sandie R. Thomson Pancreatoduodenectomy for trauma: applying novel reconstruction techniques Surgical Techniques Development Pancreatoduodenectomy Trauma Reconstruction |
| title | Pancreatoduodenectomy for trauma: applying novel reconstruction techniques |
| title_full | Pancreatoduodenectomy for trauma: applying novel reconstruction techniques |
| title_fullStr | Pancreatoduodenectomy for trauma: applying novel reconstruction techniques |
| title_full_unstemmed | Pancreatoduodenectomy for trauma: applying novel reconstruction techniques |
| title_short | Pancreatoduodenectomy for trauma: applying novel reconstruction techniques |
| title_sort | pancreatoduodenectomy for trauma applying novel reconstruction techniques |
| topic | Pancreatoduodenectomy Trauma Reconstruction |
| url | http://www.pagepress.org/journals/index.php/std/article/view/6293 |
| work_keys_str_mv | AT jakeejkrige pancreatoduodenectomyfortraumaapplyingnovelreconstructiontechniques AT sandierthomson pancreatoduodenectomyfortraumaapplyingnovelreconstructiontechniques |