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Postoperative pancreatic fistula management by gastrofistuloanastomosis – a set of case reports


Authors: J. Rudiš;  M. Ryska
Authors‘ workplace: Chirurgická klinika 2. LF UK a ÚVN Praha, přednosta: prof. MUDr. M. Ryska, CSc.
Published in: Rozhl. Chir., 2012, roč. 91, č. 11, s. 620-624.
Category: Case Report

Overview

High incidence of postoperative pancreatic fistulas after proximal pancreatoduodenectomy has lead surgeons to search for an effective approach to treatement this life-threatening complication. There is still an absence of therapeutic guidelines in this field.

The authors present 3 case reports of pancreatic fistula management with pancreaticojejunal anastomosis disconnection, retrogastric drainage and gastrofistuloanastomosis with good results.

Key words:
proximal duodenopancreatectomy – pancreatic fistula – gastrofistuloanastomosis


Sources

1. Kazanjian KK, Hines OJ, Eibl G et al. Management of pancreatic fistulas after pancreaticoduodenectomy: results in 437 consecutive patients. Arch Surg 2005;140(9):849–855.

2. Dellaportas D, Tympa A, Nastos C et al. An ongoing dispute in the management of severe pancreatic fistula: Pancreatosplenectomy or not? World Journal of Gastrointestinal Surgery 2010;11:381–384.

3. Bassi C, Dervenis C, Fingerhut A et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005;138:8–13.

4. Cullen JJ, Sarr MG, Iistrup DM. Pancreatic anastomotic leak after pancreaticoduodenectomy: incidence, significance and management. Am J Surg 1994;168:295–298.

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6. van Berge Henegouwen ML, De Wit LT, van Gulik TM et al. Incidence, risk factors and treatment of pancreatic leakage after pancreaticoduodenectomy: drainage versus resection of the pancreatic remnant. J Am Coll Surg 1997;185:18–24.

7. Fuks D, Piessen G, Heut E, Tavernier M et al. Life-threatening postoperative pancreatic fistula (grade C) after pancreaticoduodenectomy: incidence, prognosis and risk factors. Am J Surg 2009;197:702–709.

8. De Castro SM, Busch OR, van Gulik TM et al. Incidence and management of pancreatic leakage after pancreatoduodenectomy. BJS 2005;92:1117–1123.

9. Büchler MW, Wagner M, Schmied BM et al. Changes in morbidity after pancreatic resection: toward the end of completion pancreatectomy. Arch Surg 2003;138:1310–1314. Discussion 1315.

10. Haddad LB, Scatton O, Randone B et al. Pancreatic fistula after pancreaticoduodenectomy: the conservative treatment of choice. HPB (Oxford), 2009;11:203–209.

11. Bachellier P, Ousssoultzoglou E, Rosso E et al. Pancreatico gastrostomy as a salvage procedure to treat severe postoperative pancreatic fistula after Pancreaticoduodenectomy. Arch Surg 2008;143(10): 966–970.

Labels
Surgery Orthopaedics Trauma surgery

Article was published in

Perspectives in Surgery

Issue 11

2012 Issue 11
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