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1 Polish Journal of Surgery

1 2010

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Acute Pancreatitis as an Early Complication after Gastric Resection

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Merenda M. , Janczak D. , Cianciara J. , Litarski A.

tom 82

nr 12

645-650

The aim of the study was to demonstrate acute pancreatitis (AP) as an early complication after gastric resection procedures.Material and methods. Medical records were analyzed for acute pancreatitis as an early postoperative complication in patients treated in Department of Surgery of 4th Military Clinical Hospital in Wrocław between January 2000 and December 2009 who underwent gastric resection procedures. Indications for the surgical treatment included both gastric malignancy as well as complications of gastric and duodenal ulcer disease: pyloric stenosis, bleeding ulcer.Results. Between 2000 and 2009, 123 patients underwent gastric resection procedures (104 due to malignancy, 19 due to complications of gastric and duodenal ulcer disease). The overall complication rate was 32.5%: 26 patients developed general complications (cardiorespiratory failure, cardiac arrhythmias, pleural effusion, psychosis), 10 patients developed abdominal complications (fistula of the anastomosis, pancreatic fistula), infection of the postoperative wound occurred in 6 patients. Perioperative death occurred in 8 patients (mortality rate: 6.5%), including 3 patients who underwent surgical treatment in an urgent setting due to bleeding with accompanying hemorrhagic shock. Acute pancreatitis occurred in four patients (3.25%): all cases were severe and required resection of necrotic pancreatic lesions. The disorder resolved in three cases and patients were discharged home; one patient who developed additional complications, died (mortality rate: 25%).Conclusions. The reported cases of acute pancreatitis after gastric resections procedures were severe, involved pancreatic nacrosis and abscesses and required surgical intervention. Postoperative AP carries high risk of death and its successful treatment depends on properly timed surgical intervention resulting in removal of necrotic pancreatic lesions along with intensive medical treatment using e.g. parenteral nutrition and aggressive antibiotic therapy.