[Evaluation of pancreatic anastomoses in the course of radical resection].
We examine the results of radical resections performed over a 10 year period at the 2nd Department of Surgery of the University of Debrecen Medical and Health Science Center Medical School of Medicine because of chronic inflammation, tumors of the papilla of Vater or tumors of the head of the pancreas. Pancreatoduodenectomy was performed in 134 patients, Whipple-type surgery in 11, and pylorus-preserving pancreatoduodenectomy in 123 patients. Three different types of reconstructive methods were used. In pylorus-preserving pancreatoduodenectomy, the remnant of the pancreas was anastomosed by performing a termino-lateral pancreatojejunostomy in 20 cases, and a pancreatogastrostomy in 89 cases. In 14 patients, the sutures were not satisfactory because of the soft and glandular texture of the pancreas, so a new method was used. After removing the head of the pancreas, the first anastomosis was a pancreatico-jejunostomy, the second was a choledochojejunostomy, and the third was a duodeno-jejunostomy which was fixed approximately 40 centimeters from the pancreatic anastomosis. The most common complication was leaking pancreatogastrostomy. Four patients with this complication were reoperated on. The 14 patients operated on using the new method had no complications.
Arkosy
Péter
P
Debreceni Egyetem Orvos- és Egészségtudományi Centrum II. sz. Sebészeti Klinika, 4004 Debrecen.
Sasi
Szabó László
SL
Kerekes
László
L
Kovács
István
I
D000714:Anastomosis, Surgical / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D016896:Treatment Outcome