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Abstract : |
The morbidity after pancreaticoduodenectomy is very high. Different complications determined by pancreatic stump can appear: pancreatic leak (23.4%), acute pancreatitis (2.9%), hemorrhage etc. The postoperative complications rate depends by some factors: anastomosis technique (end to end, end to side, duct to mucosis), type of pancreatico-digestive anastomosis (pancreatico-jejunal or pancreatico-gastric anastomosis), the drainage of the pancreatic duct, octreotide therapy. Material and methods: 51 pancreaticoduodenectomies were performed from 1994 to 2004. In all cases we also performed a duct to mucosis pancreatico-jejunostomy. In 45 cases we made a personal type of drainage of the pancreatic duct. Octreotide was given to 32 patients. Overall postoperative morbidity was 33% with only one pancreatic fistula (2%). Mean hospital stay was 20 days and postoperative mortality was 4%. Conclusions: The drainage of the pancreatic duct and an octreotide therapy are necessary when we appreciate a high risk pancreatic stump (soft pancreas, pancreatic duct smaller then 3 mm). , |
