Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection: a clinical experimental controlled trial
Background. Despite decreasing mortality in pancreaticoduodenal resection, the incidence of postoperative complications in such patients remains high. The choice and formation of “reliable” pancreatic-enteroanastomosis remain relevant.Objectives. The improvement of immediate surgery outcomes in panc...
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| Format: | Article |
| Language: | Russian |
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Ministry of Healthcare of the Russian Federation. “Kuban State Medical University”
2021-10-01
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| Series: | Кубанский научный медицинский вестник |
| Subjects: | |
| Online Access: | https://ksma.elpub.ru/jour/article/view/2577 |
| _version_ | 1797295411942129664 |
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| author | Anton Yu. Barannikov Vladimir D. Sakhno Vladimir M. Durleshter Laura G. Izmailova Andrei V. Andreev Evgenii V. Tokarenko |
| author_facet | Anton Yu. Barannikov Vladimir D. Sakhno Vladimir M. Durleshter Laura G. Izmailova Andrei V. Andreev Evgenii V. Tokarenko |
| author_sort | Anton Yu. Barannikov |
| collection | DOAJ |
| description | Background. Despite decreasing mortality in pancreaticoduodenal resection, the incidence of postoperative complications in such patients remains high. The choice and formation of “reliable” pancreatic-enteroanastomosis remain relevant.Objectives. The improvement of immediate surgery outcomes in pancreaticoduodenal resection via development of a differentiated algorithm for pancreatic-enteroanastomosis formation.Methods. A prospective non-randomised controlled trial enrolled 90 patients with a pancreaticoduodenal resection surgery. The patients were divided in three cohorts, A (n = 30), B (n = 30) and control C (n = 30). Pancreatic shear wave ultrasound elastography was conducted pre-surgery in main cohorts A and B. Average parenchymal stiffness and intraoperative data decided between the two pancreatico-enteric anastomosis techniques, end-to-side or the original pancreatic-enteroanastomosis. Control cohort C had pancreatico-enteric anastomosis without taking into account the pancreas stiffness and macrocondition.Results. Class A postoperative pancreatic fistula was registered in 2 (6.7%) of 30 patients in cohort B; it was transient, asymptomatic, not requiring additional treatment or a longer postoperative period. No class B and C pancreatic-enteroanastomosis failures or stump pancreonecroses were observed in main cohorts A and B. Clinically significant class B and C postoperative pancreatic fistulae were registered in 5 (16.7%) of 30 patients in control cohort C (inter-cohort comparison statistically significant).Conclusion. The proposed differentiated approach to pancreatic-enteroanastomosis formation associates with a reliably low postoperative complication frequency and lack of clinically significant class B and C postoperative pancreatic fistulae. |
| first_indexed | 2024-03-07T21:47:27Z |
| format | Article |
| id | doaj.art-78de49926fa84ba0aa1986edf1342600 |
| institution | Directory Open Access Journal |
| issn | 1608-6228 2541-9544 |
| language | Russian |
| last_indexed | 2024-03-07T21:47:27Z |
| publishDate | 2021-10-01 |
| publisher | Ministry of Healthcare of the Russian Federation. “Kuban State Medical University” |
| record_format | Article |
| series | Кубанский научный медицинский вестник |
| spelling | doaj.art-78de49926fa84ba0aa1986edf13426002024-02-25T10:57:25ZrusMinistry of Healthcare of the Russian Federation. “Kuban State Medical University”Кубанский научный медицинский вестник1608-62282541-95442021-10-01285294610.25207/1608-6228-2021-28-5-29-461272Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection: a clinical experimental controlled trialAnton Yu. Barannikov0Vladimir D. Sakhno1Vladimir M. Durleshter2Laura G. Izmailova3Andrei V. Andreev4Evgenii V. Tokarenko5Territorial Clinical Hospital № 2Territorial Clinical Hospital № 2; Kuban State Medical UniversityTerritorial Clinical Hospital № 2; Kuban State Medical UniversityTerritorial Clinical Hospital № 2; Kuban State Medical UniversityTerritorial Clinical Hospital № 2; Kuban State Medical UniversityRN-Modern Technologies LLCBackground. Despite decreasing mortality in pancreaticoduodenal resection, the incidence of postoperative complications in such patients remains high. The choice and formation of “reliable” pancreatic-enteroanastomosis remain relevant.Objectives. The improvement of immediate surgery outcomes in pancreaticoduodenal resection via development of a differentiated algorithm for pancreatic-enteroanastomosis formation.Methods. A prospective non-randomised controlled trial enrolled 90 patients with a pancreaticoduodenal resection surgery. The patients were divided in three cohorts, A (n = 30), B (n = 30) and control C (n = 30). Pancreatic shear wave ultrasound elastography was conducted pre-surgery in main cohorts A and B. Average parenchymal stiffness and intraoperative data decided between the two pancreatico-enteric anastomosis techniques, end-to-side or the original pancreatic-enteroanastomosis. Control cohort C had pancreatico-enteric anastomosis without taking into account the pancreas stiffness and macrocondition.Results. Class A postoperative pancreatic fistula was registered in 2 (6.7%) of 30 patients in cohort B; it was transient, asymptomatic, not requiring additional treatment or a longer postoperative period. No class B and C pancreatic-enteroanastomosis failures or stump pancreonecroses were observed in main cohorts A and B. Clinically significant class B and C postoperative pancreatic fistulae were registered in 5 (16.7%) of 30 patients in control cohort C (inter-cohort comparison statistically significant).Conclusion. The proposed differentiated approach to pancreatic-enteroanastomosis formation associates with a reliably low postoperative complication frequency and lack of clinically significant class B and C postoperative pancreatic fistulae.https://ksma.elpub.ru/jour/article/view/2577pancreatic cancerpancreaticoduodenal resectionpancreatico-enteric anastomosisultrasound elastography |
| spellingShingle | Anton Yu. Barannikov Vladimir D. Sakhno Vladimir M. Durleshter Laura G. Izmailova Andrei V. Andreev Evgenii V. Tokarenko Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection: a clinical experimental controlled trial Кубанский научный медицинский вестник pancreatic cancer pancreaticoduodenal resection pancreatico-enteric anastomosis ultrasound elastography |
| title | Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection: a clinical experimental controlled trial |
| title_full | Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection: a clinical experimental controlled trial |
| title_fullStr | Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection: a clinical experimental controlled trial |
| title_full_unstemmed | Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection: a clinical experimental controlled trial |
| title_short | Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection: a clinical experimental controlled trial |
| title_sort | differentiated approach to pancreatic enteroanastomosis in pancreaticoduodenal resection a clinical experimental controlled trial |
| topic | pancreatic cancer pancreaticoduodenal resection pancreatico-enteric anastomosis ultrasound elastography |
| url | https://ksma.elpub.ru/jour/article/view/2577 |
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