Analysis of early hemorrhage from pancreaticojejunal anastomosis after pancreaticoduodenectomy
10.3760/cma.j.cn115396-20230601-00156
- VernacularTitle:胰十二指肠切除术后胰肠吻合口源性早期出血分析
- Author:
Shangsheng LI
1
;
Peng LI
;
Jianhua DING
;
Wenbing SUN
;
Xiangtao WANG
Author Information
1. 滨州市第二人民医院肝胆胰脾外科，滨州 256800
- Keywords:
Pancreaticoduodenectomy;
Early diagnosis;
Postoperative hemorrhage;
Pancreaticojejunal anastomosis;
Pancreaticojejunostomy;
Digestive tract reconstruction
- From:
International Journal of Surgery
2023;50(6):394-396,F2
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the therapeutic experience of early postoperative hemorrhage (EPOH) from pancreaticojejunal anastomosis after pancreaticoduodenectomy (PD).Methods:A retrospective review was conducted to summarize the clinical data of a typical case of EPOH from pancreaticojejunal anastomosis after PD in Binzhou Second People′s Hospital, and the main causes and treatment of EPOH were analyzed.Results:Due to reasons such as the slender pancreatic duct, the pancreatic duct was not found after twice transections of the pancreas during the surgery. To prevent poor pancreatic fluid drainage and related complications, the pancreatic stump was not effectively sutured, and a vertical mattress suture method was used for the pancreaticojejunal anastomosis. The patient developed severe EPOH on the surgery day. Due to the fact that the digestive tract reconstruction was a biliary pancreatic separation method, the cause of EPOH was diagnosed from pancreaticojejunal anastomosis through imaging and endoscopy. After active medical treatment, the patient recovered and was discharged.Conclusion:For the treatment of pancreatic stump after PD, precise suturing should be performed on the stump while ensuring smooth pancreatic duct drainage, in order to avoid EPOH from pancreaticojejunal anastomosis to the greatest extent possible.
