[Duct-mucosa pancreaticojejunostomy].
The subject of the study is operative-technical special features by fashioned a duct-mucosa pancreaticojejunostomy, which has been done by 15 patients. Three of the patients have been operated on a multivisceral caustic injury of an alimentary system and the rest twelve patients on a carcinoma of the pancreatic head or chronic pancreatitis. A subtotal duodenopancreatic resection has been performed on the cases with a carcinoma of the pancreatic head and chronic pancreatitis. A duodenopancreatic resection (n=3) have been done by the patients with caustic injure after a removal of an esophagus, a stomach and a part of the proximal jejunum. The operative-technical special features of the duct-mucosa pancreaticojejunostomy have been described. The postoperative mortality was 18% (n=2). The postoperative morbidity was 36% (n=4) and an anastomotic failure of the duct-mucosa pancreaticojejunostomy has been reported on two patients (18%). The consistence of the pancreas and the width of the pancreatic duct don't exert substantial influence on the leak tightness of the duct-mucosa pancreaticojejunostomy, which is an alternative operative method. A stenting of the anastomosis saves a lumen of the pancreatic duct, decreases a pressure in the jejunum and prevents an activation of the pancreatic secretion near the anastomosis.
D
D
Kostov
G
G
Kobakov
N
N
Dragnev
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome