| Title |
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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
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en
Surgical Technique for Pancreatico-enteric Anastomosis following Pancreaticoduodenectomy : A Safe and Noble Pancreaticogastrostomy with Pancreas-transfixing Method
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| Creator |
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-
ja
新地, 洋之
en
SHINCHI, Hiroyuki
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-
ja
高尾, 尊身
en
TAKAO, Sonshin
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ja
前村, 公成
en
MAEMURA, Kosei
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-
ja
又木, 雄弘
en
MATAKI, Yuko
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ja
蔵原, 弘
en
KURAHARA, Hiroshi
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-
ja
桑畑, 太作
en
KUWAHATA, Taisaku
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ja
川崎, 洋太
en
KAWASAKI, Yota
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-
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ja
飯野, 聡
en
IINO, Satoshi
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-
ja
迫田, 雅彦
en
SAKODA, Masahiko
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ja
上野, 真一
en
UENO, Shinichi
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ja
石神, 純也
en
ISHIGAMI, Sumiya
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-
ja
夏越, 祥次
en
NATSUGOE, Shoji
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| Subject |
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Other
en
pancreaticogastrostomy
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Other
en
pancreaticoduodenectomy
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Other
en
pancreas-transfixing method
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Other
en
pancreatic duct-to-gastric mucosa anastomosis
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| Description |
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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.
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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.
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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.
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| Publisher |
ja
鹿児島大学
en
Kagoshima University
|
| Date |
|
| Language |
|
| 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 |
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-
PISSN
03685063
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NCID
AN00040104
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ja
鹿児島大学医学雑誌
en
Medical journal of Kagoshima University
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Volume Number64
Issue Number1-2
Page Start1
Page End7
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| File |
|
| Oaidate |
2024-05-28 |
