지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.6
- 수록면
- 19 - 26 (8page)
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Purpose: We have summarized the experience of our institution related to what treatment has been performed in patients with pancreatic fistula and their outcome.
Methods: Seventy-eight pancreatico-enteric anastomosis failure (PEAF) patients of 403 pancreaticoduodenectomy (PD) were included for this retrospective study. PEAF was defined by the presence of rich amylase (over 10,000 IU/L) in drainage fluid at postoperative day 5 to 7 and radiographic demonstration of the anastomotic breakdown and associated local fluid collection. The management was analyzed by observation group (O group), intervention (I group) and surgery group (S group).
Results: Preoperative clinical status of the PEAF group and non-PEAF group was similar. Bile duct cancer was the highest risk subgroup of the PEAF (P=0.001) and the pancreatic adenocarcinoma showed the least risk for the PEAF (P<0.001). Among the 78 PEAF patients, 50 were managed as a conservative treatment, 15 patients were received radiologic intervention and 13 patients performed rescue surgery. Among these three subgroups, there was no statistical significance in the patient’s demographics, clinical status, surgical factors and disease nature. However, mortality was significantly higher in the S group (P<0.001). The mortality cases were developed one and six patients in O and S group, respectively. Surgical procedures in S group were completion total pancreatectomy with or without splenectomy (n=12) and pancreatectomy preserving spleen in four (28.6%). Pancreaticogastrostomy repair and Roux-en-Y pancreaticojejunostomy reconstruction were performed each case, respectively.
Conclusion: Proper drainage catheter indwelling during the PD or postoperative radiological intervention can effectively manage the PEAF without surgical interventional treatment.
Methods: Seventy-eight pancreatico-enteric anastomosis failure (PEAF) patients of 403 pancreaticoduodenectomy (PD) were included for this retrospective study. PEAF was defined by the presence of rich amylase (over 10,000 IU/L) in drainage fluid at postoperative day 5 to 7 and radiographic demonstration of the anastomotic breakdown and associated local fluid collection. The management was analyzed by observation group (O group), intervention (I group) and surgery group (S group).
Results: Preoperative clinical status of the PEAF group and non-PEAF group was similar. Bile duct cancer was the highest risk subgroup of the PEAF (P=0.001) and the pancreatic adenocarcinoma showed the least risk for the PEAF (P<0.001). Among the 78 PEAF patients, 50 were managed as a conservative treatment, 15 patients were received radiologic intervention and 13 patients performed rescue surgery. Among these three subgroups, there was no statistical significance in the patient’s demographics, clinical status, surgical factors and disease nature. However, mortality was significantly higher in the S group (P<0.001). The mortality cases were developed one and six patients in O and S group, respectively. Surgical procedures in S group were completion total pancreatectomy with or without splenectomy (n=12) and pancreatectomy preserving spleen in four (28.6%). Pancreaticogastrostomy repair and Roux-en-Y pancreaticojejunostomy reconstruction were performed each case, respectively.
Conclusion: Proper drainage catheter indwelling during the PD or postoperative radiological intervention can effectively manage the PEAF without surgical interventional treatment.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (26)
참고문헌 신청
Bassi C / 2005 / Postoperative pancreatic fistula: an international study group (ISGPF) definition / Surgery 138:8~13
DeOliveira ML / 2006 / Assessment of complications after pancreatic surgery:a novel grading system applied to 633 patients undergoing pancreaticoduodenectomy / Ann Surg 244:931~937
Bassi C / 2017 / The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula:11 years after / Surgery 161:584~591
Trede M / 1988 / The complications of pancreatectomy / Ann Surg 207:39~47
Miedema BW / 1992 / Complications following pancreaticoduodenectomy. Current management / Arch Surg 127:945~949
DeOliveira ML / 2006 / Assessment of complications after pancreatic surgery:a novel grading system applied to 633 patients undergoing pancreaticoduodenectomy / Ann Surg 244:931~937
Bassi C / 2017 / The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula:11 years after / Surgery 161:584~591
Trede M / 1988 / The complications of pancreatectomy / Ann Surg 207:39~47
Miedema BW / 1992 / Complications following pancreaticoduodenectomy. Current management / Arch Surg 127:945~949
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