title: [Use of the round ligament of the liver to prevent post-pancreatectomy hemorrhage].
abstract: Rupture of a pseudoaneurysm after pancreaticoduodenectomy is a fatal complication. To prevent this, we used the round ligament of the liver to separate the hepatic artery from pancreatic anastomosis, obtaining good results. The procedure involved detaching the round ligament of the liver from the abdominal wall during laparotomy and winding it from the proper and common hepatic artery mainly on a gastroduodenal artery stump after reconstruction. Postoperative computed tomography (CT) scan revealed that a thick layer of fat separated the hepatic artery from the abdominal abscess. We retrospectively analyzed 56 patients who had undergone pancreaticoduodenectomy at Tsubame Rosai Hospital from 2003 until 2012. The round ligament was used for 22 patients( ligament group) and was not used for 34 patients( non-ligament group). There was no difference in morbidity from intra-abdominal abscess and pancreatic fistula between the ligament and non-ligament group. Intra-abdominal hemorrhage occurred in 2 patients( 5.9%) in the non-ligament group but did not occur in the ligament group. We believe that this procedure is easy and useful for the prevention of post-pancreatectomy hemorrhage.
authors.affiliation: Dept. of Surgery, Tsubame Rosai Hospital.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakatsuka
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sawatsubashi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Morioka
authors.forename: Takao
authors.initials: T
authors.lastname: Shimizu
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000209:etiology / Q000517:prevention & control*; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D004379:Duodenal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008099:Liver / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*