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Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Reevaluating pancreatic duct ligation in Whipple procedure
I N Nomikos1, N Farmakis, A Zizi
1Department of Surgery-B, "Metaxa" Cancer Hospital, Piraeus, Greece. nomikosj@otenet.gr
Journal of B.U.ON. : Official Journal of the Balkan Union of Oncology
|December 11, 2007
Summary
Pancreatic duct ligation (PDL) after pancreaticoduodenectomy (PPD) offers a safe alternative to pancreaticojejunostomy. While PDL can cause fistulas, it avoids major complications like diabetes and pancreatic insufficiency.
Area of Science:
- Gastroenterology and Surgical Oncology
Background:
- Pancreaticoduodenectomy (Whipple procedure) carries risks associated with pancreaticojejunal anastomosis.
- Alternative methods for managing the pancreatic stump are needed to reduce morbidity and mortality.
Observation:
- A series of 9 unselected patients underwent pancreatic duct ligation (PDL) following pancreaticoduodenectomy (PPD).
- The study included patients with pancreatic cancer and chronic pancreatitis.
Findings:
- Pancreatic fistula occurred in 4 patients, persisting for 14-58 days (mean 35.4 days).
- No patients developed diabetes mellitus, acute pancreatitis, or pancreatic insufficiency post-PDL.
- Two patients died within 30 days from causes unrelated to PDL.
Implications:
- PDL is a safe, simple, and fast alternative to pancreaticojejunostomy.
- PDL may result in a controlled pancreaticocutaneous fistula, but without significant metabolic complications.
