Morbidity and Mortality of the End to End Pancreaticojejunostomy usign the Stent in Pancreaticoduodenectomy : Experience with 43 Patients.
- Author:
Do Hoon KIM
1
;
Moon Soo LEE
;
Chang Ho KIM
;
Ok Pyung SONG
;
Moo Sik CHO
;
Hee Ju PARK
Author Information
1. Department of Surgery, College of Medicine, Soon Chun Hyang University, Chonan, Korea.
- Publication Type:Original Article
- Keywords:
Morbidity;
Mortality;
Dunkong method;
Pancreaticojejunostomy;
Pancreati-coduodenectomy
- MeSH:
Abscess;
Ampulla of Vater;
Bilirubin;
Choledochal Cyst;
Common Bile Duct;
Drainage;
Duodenal Neoplasms;
Emergencies;
Female;
Head and Neck Neoplasms;
Hemorrhage;
Humans;
Intestinal Obstruction;
Liver Failure;
Male;
Mortality*;
Pancreaticoduodenectomy*;
Pancreaticojejunostomy*;
Pancreatitis, Chronic;
Polyethylene;
Postoperative Care;
Postoperative Complications;
Prothrombin Time;
Serum Albumin;
Stents*;
Stomach Neoplasms;
Wound Infection
- From:Journal of the Korean Surgical Society
1997;53(6):885-894
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Although many improvements have been made in surgical technique, as well as preoperative and postoperative care, the pancreaticoduodenectomy remains a technically difficult procedure attended by relatively high morbidity and mortality rates. This study concerns a total of 43 patients that underwent a pancreaticojejunostomy using a polyethylene stent by the Dunking method in a pancreaticoduodenectomy at Soon Chun Hyang University Hospital from January 1990 to December 1996. The results obtained are as follows:1) In our study, there were 13 patients with pancreatic head cancer, 11 patients with ampulla of Vater cancer, 5 patients with distal common bile duct cancer, 4 patients with duodenal cancer, 3 patients with chronic pancreatitis, 3 patients with trauma, 3 patients with a choledochal cyst, 1 patient with stomach cancer. 2) There were 23 men (53.5%) and 20 women (46.5%). 3) Postoperative complications developed in 25 patients (58.1%). Of the complications, bleeding was the most commonly observed, after which, in order of frequency, wound infection, leakage at the anastomotic site, intestinal obstruction, and intraabdominal abscess were also observed. 4) The overall operative mortality was 13.9% (excluding emergency cases, mortality was 7.5 %). Four patients died of intraabdominal or gastrointestinal bleeding, one patient died of pancreatic leakage, and one of hepatic failure. 5) Transfusion during the operation (above 5 pints) was significantly correlated with operative morbidity. Preoperative percutaneous transhepatic biliary drainage (PTBD) with serum bilirubin greater than 10 mg/dl significantly decreased the operative morbidity. 6) A prothrombin time more than 13.9 second, serum albumin less than 3.0 g/dl, and an emergency operation were significantly correlated with operative mortality.