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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
Alternative
  • Surgical Technique for Pancreatico-enteric Anastomosis following Pancreaticoduodenectomy : A Safe and Noble Pancreaticogastrostomy with Pancreas-transfixing Method
  • スイトウ ジュウニシチョウ セツジョジュツ ニオケル スイショウカカン フンゴウ ノ シュジュツ シュギ : アンゼン カクジツナ スイイ ミッチャク フンゴウホウ
Creator

新地, 洋之

高尾, 尊身

前村, 公成

又木, 雄弘

蔵原, 弘

桑畑, 太作

川崎, 洋太

南, 幸次

飯野, 聡

迫田, 雅彦

上野, 真一

石神, 純也

夏越, 祥次

Subject
  • Other pancreaticogastrostomy
  • Other pancreaticoduodenectomy
  • Other pancreas-transfixing method
  • Other pancreatic duct-to-gastric mucosa anastomosis
  • NDC 494
Description
Other
  • type:論文(Article)
Other
  • 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 pancreaticremnant.
Other
  • Methods: As for the pancreaticogastrostomy technique, an ultrasonically activated scalpel was used for transecting thepancreas. The inner layer involves a duct-to-mucosa anastomosis with an internal stent and the outer layer involves a singlerow pancreas-transfixing sutures between the pancreatic remnant and the posterior gastric wall.
Other
  • Results: A total of 228 consecutive patients underwent pancreaticoduodenectomy with pancreaticogastrostomy. Ofthe 228 study patients, 154 patients (67%) had a soft pancreas. There was no operative or hospital death. Postoperativecomplications occurred in 38 patients (17%). Pancreatic fistula (Grade B/C) occurred in 4 patients (1.8%) with a soft thinpancreas. 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 therisk of suture injury of the pancreas and by embedding the transected stump into the wall of the stomach. This novelpancreaticogastrostomy can be recommended as an effective reconstructive procedure, especially for patients with a soft,nonfibrotic pancreas.
Publisher鹿児島大学
Date Created 2016-10-28
Languagejpn
NIItypedepartmental bulletin paper
VersiontypeVoR
Identifier URI http://hdl.handle.net/10232/15977
Journal
    • NCID AN00040104
    • ISSN 0368-5063
    • 鹿児島大学医学雑誌=Medical journal of Kagoshima University
    64(1-2), 1-7
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Oaidate2019-11-22T06:55:00Z