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Updated: Aug 29, 2026
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Completion pancreatectomy for postoperative peritonitis after pancreaticoduodenectomy: early and late outcome
Sylvie Gueroult1, Yann Parc, Françoise Duron
1Department of Digestive Surgery, Hôpital Saint-Antoine, Assistance Publique/Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.
Hypothesis:
Completion pancreatectomy in patients with pancreatic leakage associated with postoperative peritonitis after pancreaticoduodenectomy is a viable salvage procedure.
Design:
Retrospective analysis from a cohort of consecutive patients admitted between January 1, 1989, and December 31, 1999, for postoperative peritonitis originating from pancreaticojejunostomy leakage.
Setting:
Tertiary referral center with surgical intensive care unit specializing in the treatment of intra-abdominal sepsis.
Patients:
Eight consecutive patients with postoperative peritonitis originating from pancreaticojejunostomy after pancreaticoduodenectomy, with a mean Acute Physiology and Chronic Health Evaluation II score of 18.6. We excluded patients with pancreatic fistulas or abscesses amenable to percutaneous drainage or other conservative treatment.
Intervention:
Completion pancreatectomy.
Main Outcome Measures:
Mortality, morbidity, and long-term outcome, which was assessed by interview.
Results:
Three patients died in the postoperative period: 2 required early reoperation during the postoperative period and died of hemorrhage and sepsis, and 1 died of multiorgan failure without reoperation. Recurrence of carcinoma was responsible for late death of 2 other patients.
Conclusions:
Postoperative peritonitis after pancreaticoduodenectomy still has high mortality; however, completion pancreatectomy may represent the only means to achieve source control of infection in cases of postoperative peritonitis.
