ABSTRACT
INTRODUCCIÓN: La técnica de la reconstrucción pancreática tras duodenopancreatectomía cefálica con conservación del píloro mediante bipartición gástrica (DPC-BG) parece asociarse a una mejor evolución postoperatoria en comparación con la pancreaticoyeyunostomía convencional en el marco de un estudio aleatorizado prospectivo. El objetivo de este estudio es evaluar aún más el resultado quirúrgico en una serie de 129 pacientes consecutivos. MÉTODOS: Entre 2007 y junio de 2013, se analizaron retrospectivamente un total de 129 pacientes con tumores periampulares tratados quirúrgicamente con DPC-BG. Se analizaron los resultados a partir de las complicaciones precoces quirúrgicas (escala de Clavien-Dindo), así como las complicaciones relacionadas y no relacionadas con el páncreas. RESULTADOS: La tasa de complicación postoperatoria global fue del 77%, aunque el 50% de las complicaciones se clasificaron I-II en la clasificación Clavien-Dindo. La incidencia de la fístula pancreática clínicamente relevante fue del 18% (tipo ISGFP B: 12%, tipo ISGFP C: 6%). Otras complicaciones específicas del páncreas tales como retraso del vaciamiento gástrico y hemorragia pospancreatectomía fueron del 27 y del 15%, respectivamente, similares a los resultados publicados en la literatura. La tasa de mortalidad perioperatoria global fue del 4,6%. CONCLUSIÓN: Los resultados de la DPC-BG muestran que es una técnica segura, con una morbilidad aceptable, baja mortalidad y tasa de fístula pancreática similar a otras técnicas actualmente descritas de reconstrucción pancreaticoentérica
INTRODUCTION: Pylorus-preserving pancreatoduodenectomy with gastric partition (PPPD-GP) seems to be associated to a better postoperative outcome than conventional pancreaticojejunostomy in the setting of a prospective-randomized study. The aim of this study is to further evaluate the surgical outcome in a series of 129 consecutive patients. METHODS: Between 2007 and June 2013, 129 patients with periampullary tumors surgically treated with PPPD-GP were retrospectively analyzed. Surgical complications (Clavien-Dindo score), as well as pancreatic and non-pancreas related complications were analyzed. RESULTS: Overall postoperative complication rate was 77%, although 50% of complications were graded I-II by the Clavien-Dindo classification. Incidence of clinically relevant pancreatic fistula was 18%: ISGFP type B: 12%, and type C: 6%. Other pancreas specific complications such as delayed gastric emptying and pospancreatectomy haemorrhage were 27 and 15%, respectively, similar to results published in the literature. Overall perioperative mortality rate was 4.6%. CONCLUSION: PPPD-GP results show that it is a technique with an acceptable morbidity, low mortality and pancreatic fistula rate similar to other techniques currently described of pancreaticoenteric reconstruction
Subject(s)
Humans , Anastomosis, Surgical/methods , Gastric Bypass/methods , Pancreatic Fistula/surgery , Ampulla of Vater/surgery , Pancreaticojejunostomy , Pancreaticoduodenectomy , Gastrostomy/methods , Retrospective Studies , Abdominal Neoplasms/surgery , Organ Sparing Treatments/methodsABSTRACT
INTRODUCTION: Pylorus-preserving pancreatoduodenectomy with gastric partition (PPPD-GP) seems to be associated to a better postoperative outcome than conventional pancreaticojejunostomy in the setting of a prospective-randomized study. The aim of this study is to further evaluate the surgical outcome in a series of 129 consecutive patients. METHODS: Between 2007 and June 2013, 129 patients with periampullary tumors surgically treated with PPPD-GP were retrospectively analyzed. Surgical complications (Clavien-Dindo score), as well as pancreatic and non-pancreas related complications were analyzed. RESULTS: Overall postoperative complication rate was 77%, although 50% of complications were graded I-II by the Clavien-Dindo classification. Incidence of clinically relevant pancreatic fistula was 18%: ISGFP type B: 12%, and type C: 6%. Other pancreas specific complications such as delayed gastric emptying and pospancreatectomy haemorrhage were 27 and 15%, respectively, similar to results published in the literature. Overall perioperative mortality rate was 4.6%. CONCLUSION: PPPD-GP results show that it is a technique with an acceptable morbidity, low mortality and pancreatic fistula rate similar to other techniques currently described of pancreaticoenteric reconstruction.
