Toward zero pancreatic fistula after pancreaticoduodenectomy with pancreaticogastrostomy

被引:34
作者
Rosso, Edoardo
Bachellier, Philippe
Oussoultzoglo, Elie
Scurtu, Radu
Meyer, Nicolas
Nakano, Hiroshi
Verasay, Guillermo
Jaeck, Daniel [1 ]
机构
[1] Univ Strasbourg 1, Hautepierre Hosp, Hop Univ Strasbourg, Ctr Chirurg Viscerale & Transplantat, F-67200 Strasbourg, France
[2] Univ Strasbourg 1, Dept Med Informat, Strasbourg, France
关键词
pancreaticogastrostomy; morbidity; pancreatic fistula; surgical outcome;
D O I
10.1016/j.amjsurg.2005.09.012
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Postoperative morbidity after pancreaticoduodenectomy has been associated mainly with the development of pancreatic fistula. However, postoperative complications unrelated to pancreatic fistula cannot be disregarded after pancreaticoduodenectomy. The aim of the present study was to investigate the postoperative morbidity in a large series of pancreaticoduodenectomies with pancreaticogastrostornies without pancreatic fistula. Methods: The present study analyzed the data from 194 consecutive patients undergoing a pancreaticoduodenectomy with a pancreaticogastrostomy between July 1997 and June 2003 in whom no postoperative pancreatic fistula occurred. Results: The overall rate of postoperative morbidity was 33.5%. Specific and general complications occurred in 16% and 17.5% of the patients, respectively. An American Society of Anesthesiologists (ASA) score of 3 and blood transfusion were the only independent factors associated with postoperative morbidity. Conclusions: Our study found that the overall morbidity after a pancreaticoduodenectomy with a pancreaticogastrostomy still remains high even in the absence of pancreatic fistula and is associated with the preoperative medical condition (ASA score) of the patients and with blood transfusion. (c) 2006 Excerpta Medica Inc. All rights reserved.
引用
收藏
页码:726 / 732
页数:7
相关论文
共 40 条
[1]   Risk factors for complications after pancreatic head resection [J].
Adam, U ;
Makowiec, F ;
Riediger, H ;
Schareck, WD ;
Benz, S ;
Hopt, UT .
AMERICAN JOURNAL OF SURGERY, 2004, 187 (02) :201-208
[2]  
Adloff M, 1992, Chirurgie, V118, P63
[3]  
Andivot T, 1996, ANN CHIR, V50, P431
[4]  
[Anonymous], J AM COLL SURG
[5]   Zero mortality after 152 consecutive pancreaticoduodenectomies with pancreaticogastrostomy [J].
Aranha, GV ;
Hodul, PJ ;
Creech, S ;
Jacobs, W .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2003, 197 (02) :223-231
[6]  
Arnaud JP, 1999, EUR J SURG, V165, P357
[7]   Pancreatic fistula rate after pancreatic resection - The importance of definitions [J].
Bassi, C ;
Butturini, G ;
Molinari, E ;
Mascetta, G ;
Salvia, R ;
Falconi, M ;
Gumbs, A ;
Pederzoli, P .
DIGESTIVE SURGERY, 2004, 21 (01) :54-59
[8]   AMERICAN-COLLEGE OF CHEST PHYSICIANS SOCIETY OF CRITICAL CARE MEDICINE CONSENSUS CONFERENCE - DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].
BONE, RC ;
BALK, RA ;
CERRA, FB ;
DELLINGER, RP ;
FEIN, AM ;
KNAUS, WA ;
SCHEIN, RMH ;
SIBBALD, WJ ;
ABRAMS, JH ;
BERNARD, GR ;
BIONDI, JW ;
CALVIN, JE ;
DEMLING, R ;
FAHEY, PJ ;
FISHER, CJ ;
FRANKLIN, C ;
GORELICK, KJ ;
KELLEY, MA ;
MAKI, DG ;
MARSHALL, JC ;
MERRILL, WW ;
PRIBBLE, JP ;
RACKOW, EC ;
RODELL, TC ;
SHEAGREN, JN ;
SILVER, M ;
SPRUNG, CL ;
STRAUBE, RC ;
TOBIN, MJ ;
TRENHOLME, GM ;
WAGNER, DP ;
WEBB, CD ;
WHERRY, JC ;
WIEDEMANN, HP ;
WORTEL, CH .
CRITICAL CARE MEDICINE, 1992, 20 (06) :864-874
[9]  
Böttger TC, 1999, WORLD J SURG, V23, P164
[10]   100 AND 45 CONSECUTIVE PANCREATICODUODENECTOMIES WITHOUT MORTALITY [J].
CAMERON, JL ;
PITT, HA ;
YEO, CJ ;
LILLEMOE, KD ;
KAUFMAN, HS ;
COLEMAN, J ;
HERRINGTON, JL ;
MASON, GR ;
BRADLEY, EL ;
JORDAN, GL ;
GADACZ, TR ;
VANHEERDEN, JA ;
WATKINS, GH ;
COPELAND, EH .
ANNALS OF SURGERY, 1993, 217 (05) :430-438