title: Pylorus-preserving pancreaticoduodenectomy in patients undergoing chronic hemodialysis.
abstract: This report describes three patients who underwent a pylorus-preserving pancreaticoduodenectomy (PpPD) and received maintenance hemodialysis due to chronic renal failure. The three cases were diagnosed to have bile duct cancer, intraductal papillary mucinous neoplasm, and carcinoma of the ampulla of Vater, respectively. They underwent chronic hemodialysis for 7.7 years. They all underwent a PpPD with lymph node dissection. The mean operation time was 373 min and mean blood loss was 647 ml. During the postoperative courses, hemodialysis was restarted on postoperative day 1 in all three cases. In the three patients, only minor complications were experienced and these were treated conservatively. The mean postoperative hospital stay was 48 days. Two patients are still alive 135 and 21 months after the operation, respectively, but the other patient died of another disease 21 months after the PpPD. A PpPD may therefore be safe and feasible even in patients receiving chronic hemodialysis.
authors.affiliation: Department of Surgery I, Oita University Faculty of Medicine, 1-1 Hasama-machi, Yufu, Oita, 879-5593, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Uchida
authors.forename: Kohei
authors.initials: K
authors.lastname: Shibata
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Kai
authors.forename: Kentaro
authors.initials: K
authors.lastname: Iwaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohta
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitano
mesh_terms: D000368:Aged; D014670:Ampulla of Vater; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000453:epidemiology / Q000601:surgery; D015897:Comorbidity; D000075202:Contraindications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000379:methods*; D006435:Renal Dialysis