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2015 | 87 | 6 | 307-311
Tytuł artykułu

Preoperative pancreatic duct stenting in patients undergoing laparoscopic pancreatic surgery – a preliminary report

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Laparoscopic surgery is becoming an approved technique in pancreatic surgery. It offers some advantages over an open approach due to shorter hospital stay and decreased complication rate. Regardless the technique the most significant problem of pancreatic surgery is postoperative pancreatic fistula. There are numerous methods attempted at reduction of its incidence. One of the possibilities is preoperative pancreatic duct stenting. It aims at decreasing the pressure in the pancreatic duct, which is supposed to facilitate pancreatic juice flow to the duodenum. The aim of the study was to determine the role of preoperative pancreatic duct stenting in pancreatic surgery. Material and methods. Nineteen patients undergoing laparoscopic pancreatic resection were enrolled into the study. Prior to the surgery, all of the patients were submitted for the Endoscopic Retrograde Choleangiopancreatography (ERCP) with pancreatic duct stenting. Following the subsequent laparoscopic pancreatic resection, all patients were monitored to detect the pancreatic fistula appearance. The pancreatic stent was removed 6‑8 weeks after the surgery. Results. With an exception of two patients, all other patients underwent successful ERCP with pancreatic duct stenting before the surgery. In one case the placement of the prosthesis failed due to a tortuous pancreatic duct. Five patients had an episode of acute pancreatitis including two severe courses as a complication of preoperative ERCP. One of the patient died due to severe GI bleeding 2 weeks after stenting. Among the procedures there were 15 distal pancreatectomies, two enucleations of the tumor localized in the uncinate process and in the body of the pancreas and one central pancreatectomy. The median time of surgery duration was 186 minutes (90‑300; ±56). No conversions to an open approach were necessary. Likewise, there was neither any major complications reported in a postoperative course nor incidence of pancreatic fistula in any of the patients undergoing surgery. Conclusions. Preoperative pancreatic duct stenting can decrease the incidence of pancreatic fistula. However, a number of serious complications exceed the potential benefit of this method.
Wydawca
Rocznik
Tom
87
Numer
6
Strony
307-311
Opis fizyczny
Daty
wydano
2015-06-01
otrzymano
2015-05-21
online
2015-08-04
Twórcy
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow Kierownik
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow Kierownik
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow Kierownik
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow Kierownik
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow Kierownik
Bibliografia
  • 1. DiNorcia J, Schrope BA, Lee MK et al.: Laparoscopic distal pancreatectomy offers shorter hospital stays with fewer complications. J Gastrointest Surg 2010 Nov; 14(11): 1804‑12.
  • 2. Xie K, Zhu YP, Xu XW et al.: Laparoscopic distal pancreatectomy is as safe and feasible as open procedure: a meta-analysis. World J Gastroenterol 2012 Apr 28; 18(16): 1959‑67.
  • 3. Stauffer JA, Rosales-Velderrain A, Goldberg RF et al.: Comparison of open with laparoscopic distal pancreatectomy: a single institution’s transition over a 7-year period. HPB (Oxford). 2013 Feb; 15(2): 149‑55.
  • 4. Bassi C, Dervenis C, Butturini G et al.: International Study Group on Pancreatic Fistula Definition.
  • Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005
  • Jul; 138(1): 8‑13.
  • 5. Lee TH, Moon JH, Choi HJ et al.: Prophylactic temporary 3F pancreatic duct stent to prevent post-ERCP pancreatitis in patients with a difficult biliary cannulation: a multicenter, prospective, randomized study. Gastrointest Endosc 2012 Sep; 76(3): 578‑85.
  • 6. Yoshiaki K, Masami O, Fumio O et al.: Randomized controlled trial of pancreatic stenting to prevent pancreatitis after endoscopic retrograde cholangiopancreatography. World J Gastroenterol 2012 Apr 14; 18(14): 1635‑41.
  • 7. Frozanpor F, Lundell L, Segersvärd R, Arnelo U: The Effect of Prophylactic Transpapillary Pancreatic Stent Insertion on Clinically Significant Leak Rate Following Distal Pancreatectomy: results of a Prospective Controlled Clinical Trial. Ann Surg 2012 Jun; 255(6): 1032‑36.
  • 8. Rieder B1, Krampulz D, Adolf J et al.: The Effect of Prophylactic Transpapillary Pancreatic Stent Insertion on Clinically Significant Leak Rate Following Distal Pancreatectomy. Gastrointest Endosc 2010 Sep; 72(3): 536‑42.
  • 9. Zhou Y, Zhou Q, Li Z, Chen R: Internal pancreatic duct stent does not decrease pancreatic fistula rate after pancreatic resection: a meta-analysis.
  • Am J Surg 2013 Jun; 205(6): 718‑25.
  • 10. Wu X, Li M, Wu W et al.: The role of prophylactic transpapillary pancreatic stenting in distal pancreatectomy: a meta-analysis. Front Med 2013
  • Dec; 7(4): 499‑505.
  • 11. Bakker OJ, van Baal MC, van Santvoort HC et al.: Dutch Pancreatitis Study Group. Endoscopic transpapillary stenting or conservative treatment for pancreatic fistulas in necrotizing pancreatitis: multicenter series and literature review. Ann Surg 2011 May; 253(5): 961‑67.
  • 12. Reddymasu SC, Pakseresht K, Moloney B et al.: Incidence of pancreatic fistula after distal pancreatectomy and efficacy of endoscopic therapy for its management: results from a tertiary care center.
  • Case Rep Gastroenterol 2013 Aug 16; 7(2): 332‑39.
  • 13. Andriulli A, Loperfido S, Napolitano G et al.: Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol 2007 Aug; 102(8): 1781‑8.
  • 14. Christensen M, Matzen P, Schulze S, Rosenberg J: Complications of ERCP: a prospective study.
  • Gastrointest Endosc 2004 Nov; 60(5): 721‑31.
  • 15. Aycan A, Goretzki PE, Wirowski D et al.: Is the covering of the resection margin after distal pancreatectomy advantageous? Eur J Med Res 2013
  • Sep 28; 18: 33.
  • 16. Bu X, Xu Y, Xu J, Dai X: Continuous irrigation around pancreatic remnant decreases pancreatic fistula-related intraabdominal complications after distal pancreatectomy. Langenbecks Arch Surg 2013 Dec; 398(8): 1083‑89
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_1515_pjs-2015-0059
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