Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Wiltberger, G; Schmelzle, M; Tautenhahn, HM; Krenzien, F; Atanasov, G; Hau, HM; Moche, M; Jonas, S.
Alternative treatment of symptomatic pancreatic fistula.
J Surg Res. 2015; 196(1): 82-9.
Doi: 10.1016/j.jss.2015.02.047
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Hau Hans-Michael
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- Abstract:
- BACKGROUND: The management of symptomatic pancreatic fistula after pancreaticoduodenectomy is complex and associated with increased morbidity and mortality. We here report continuous irrigation and drainage of the pancreatic remnant to be a feasible and safe alternative to total pancreatectomy. MATERIALS AND METHODS: Between 2005 and 2011, patients were analyzed, in which pancreaticojejunal anastomosis was disconnected because of grade C fistula, and catheters for continuous irrigation and drainage were placed close to the pancreatic remnant. Clinical data were monitored and quality of life was evaluated. RESULTS: A total of 13 of 202 patients undergoing pancreaticoduodenectomy required reoperation due to symptomatic pancreatic fistula. Ninety-day mortality of these patients was 15.3%. Median length of stay on the intensive care unit and total length of stay was 18 d (range 3-45) and 46 d (range 33-96), respectively. Patients with early reoperation (<10 d) had significantly decreased length of stay on the intensive care unit and operation time (P < 0.05). Global health status after a median time of 22 mo (range 6-66) was nearly identical, when compared with that of a healthy control group. Mean follow-up was 44.4 mo (±27.2). Four patients (36.6 %) died during the follow-up period; two patients from tumor recurrence, one patient from pneumonia, and one patient for unknown reasons. CONCLUSIONS: Treatment of pancreatic fistula by continuous irrigation and drainage of the preserved pancreatic remnant is a simple and feasible alternative to total pancreatectomy. This technique maintains a sufficient endocrine function and is associated with low mortality and reasonable quality of life.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Drainage - administration & dosage
- Female - administration & dosage
- Humans - administration & dosage
- Length of Stay - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Pancreatic Fistula - mortality, surgery
- Pancreaticoduodenectomy - administration & dosage
- Therapeutic Irrigation - administration & dosage
- Find related publications in this database (Keywords)
- Pancreatic fistula
- Irrigation
- Pancreaticoduodenectomy