[Anastomosis or closure of the pancreatic stump after duodenopancreatectomy?].
From 1986 to June 1990, 10 pancreaticoduodenectomies were performed in our Department (VIII Patologia Chirurgica, Università "La Sapienza", Roma). The reconstructive sequence was based on the pancreaticojejunal anastomosis (2 end-to-end pancreaticojejunostomies after invagination, 3 end-to-side Wirsung jejunostomies) in 5 patients. The pancreatic stump was sutured using a 50mm linear stapler in the remaining 5 patients. There was a high incidence (75%) of fistulization after direct suture of the pancreatic stump, although related mortality was null. Among patients treated with pancreaticojejunal anastomosis, a fistula on the end-to-end pancreaticojejunostomy with exitus of the patient, was registered in 1 case. On principle, we believe a end-to-side Wirsung jejunostomy should be performed after pancreaticoduodenectomy. When a safe anastomosis of the pancreatic stump cannot be performed (because of the soft parenchyma, easily lacerable) the technique of the direct suture with stapler is advisable.
Marchesi
M
M
Istituto di III Clinica Chirugica, Università degli Studi La Sapienza, Roma.
Biffoni
M
M
Tartaglia
F
F
Nobili-Benedetti
R
R
Orlando
M
M
Lentini
A
A
Stocco
F
F
Campana
F P
FP
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D014670:Ampulla of Vater; D000714:Anastomosis, Surgical; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery
Anastomosi o chiusura del moncone pancreatico dopo duodenocefalopancreatectomia?