Volume : VII, Issue : VIII, August - 2017

Pancreatic stump management following Pancreatico duodenectomy– Outcome analysis of various reconstruction techniques

Prabhakaran Raju

Abstract :

 Background:

Pancreatic stump anastomosis is the Achilles heel after Whipple’s Procedure. The morbidity (40–60%) and mortality (1–5%)following Whipple Procedure is related to the outcome of anastomosis. The aftermath of a pancreatic leak can be devastating, particularly when it results in retroperitoneal sepsis. This is found to be a major cause

of mortality in whipples procedure [1]. Effects to improvise the anastomostic techniques and thereby outcome of Whipple procedure is still evolving. Though many randomized and prospective studies are available till date no simple best technique had been recommended.

 

Aim of the study:

To analyse the outcome of pancreatic stump anastomosis of various types in relation to major and minor morbidities and mortality in relation to individual type of anastomosis.

Materials and methods:

Retrospective analysis of prospectively collected data from 2010 to 2014 march on patients underwent Whipple procedure done – 138 patients have undergone Whipple procedure. Preoperative, Intraoperative and postoperative variables were taken for this study. All patients admitted with a diagnosis of periampullary carcinoma or carcinoma head of pancreas were evaluated by imaging studies and those patients found to have resectable disease were selected for study. All data were collected prospectively and the clinical parameters were noted in a proforma. Details noted included age, gender, chief complaints, co–morbid illness, nature of diet, habit of smoking and alcohol consumption were also noted. Findings on physical examination such as jaundice, pallor, pedal edema and other signs of liver failure if present were noted.  Clinical examination of the abdomen was done to look for a palpable gallbladder, hepatomegaly and free fluid. rectal examination to rule out any possibility of rectal deposits. Basic biochemical and hematologic investigations including a complete blood count, Renal function tests and Liver function tests were noted. Coagulation profile and serum tumour marker study was done for all patients. After an initial ultrasonogram of abdomen, an upper GI endoscopy and contrast enhanced computerised tomography was done for all patients.

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Prabhakaran Raju, Pancreatic stump management following Pancreatico duodenectomy– Outcome analysis of various reconstruction techniques, INDIAN JOURNAL OF APPLIED RESEARCH : Volume‾7 | Issue‾8 | August‾2017

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