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Title
  • ja 膵頭十二指腸切除術における膵消化管吻合の手術手技 : 安全確実な膵胃密着吻合法
  • en Surgical Technique for Pancreatico-enteric Anastomosis following Pancreaticoduodenectomy : A Safe and Noble Pancreaticogastrostomy with Pancreas-transfixing Method
Creator
    • ja 新地, 洋之 en SHINCHI, Hiroyuki
    • ja 高尾, 尊身 en TAKAO, Sonshin
    • ja 前村, 公成 en MAEMURA, Kosei
    • ja 又木, 雄弘 en MATAKI, Yuko
    • ja 蔵原, 弘 en KURAHARA, Hiroshi
    • ja 桑畑, 太作 en KUWAHATA, Taisaku
    • ja 川崎, 洋太 en KAWASAKI, Yota
    • ja 南, 幸次 en MINAMI, Koji
    • ja 飯野, 聡 en IINO, Satoshi
    • ja 迫田, 雅彦 en SAKODA, Masahiko
    • ja 上野, 真一 en UENO, Shinichi
    • ja 石神, 純也 en ISHIGAMI, Sumiya
    • ja 夏越, 祥次 en NATSUGOE, Shoji
Subject
  • Other en pancreaticogastrostomy
  • Other en pancreaticoduodenectomy
  • Other en pancreas-transfixing method
  • Other en pancreatic duct-to-gastric mucosa anastomosis
Description
  • Other en Background and Purpose: Pancreatic anastomotic leak remains a persistent problem after pancreaticoduodenectomy. The presence of soft, nonfibrotic pancreatic tissue is one of the most important risk factors for pancreatic leak. Accordingly, we devised a pancreas-transfixing suture method for pancreaticogastrostomies in patients with a soft, nonfibrotic pancreatic remnant.
  • Other en Methods: As for the pancreaticogastrostomy technique, an ultrasonically activated scalpel was used for transecting the pancreas. The inner layer involves a duct-to-mucosa anastomosis with an internal stent and the outer layer involves a single row pancreas-transfixing sutures between the pancreatic remnant and the posterior gastric wall.
  • Other en Results: A total of 228 consecutive patients underwent pancreaticoduodenectomy with pancreaticogastrostomy. Of the 228 study patients, 154 patients (67%) had a soft pancreas. There was no operative or hospital death. Postoperative complications occurred in 38 patients (17%). Pancreatic fistula (Grade B/C) occurred in 4 patients (1.8%) with a soft thin pancreas. These pancreatic leaks were managed nonoperatively by maintaining the closed drains. Conclusion: This technique is simple and appears to reduce the risk of pancreatic leakage possibly by decreasing the risk of suture injury of the pancreas and by embedding the transected stump into the wall of the stomach. This novel pancreaticogastrostomy can be recommended as an effective reconstructive procedure, especially for patients with a soft, nonfibrotic pancreas.
Publisher ja 鹿児島大学 en Kagoshima University
Date
    Issued2012-09-01
Language
  • jpn
Resource Type departmental bulletin paper
Version Type VoR
Identifier HDL http://hdl.handle.net/10232/15977 , URI https://ir.kagoshima-u.ac.jp/records/5301
Journal
    • PISSN 03685063
    • NCID AN00040104
      • ja 鹿児島大学医学雑誌 en Medical journal of Kagoshima University
      • Volume Number64 Issue Number1-2 Page Start1 Page End7
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Oaidate 2024-05-28