Pancreaticojejunal bridge-anastomosis: a novel option for surgeon to preserve pancreatic body and tail in urgent reoperation for intra-abdominal massive hemorrhage after pancreaticoduodenectomy.

World Journal of Surgery
Jin XuXiaobo Zhang

Abstract

Postoperative intra-abdominal massive bleeding is a rare and life-threatening complication associated with pancreaticoduodenectomy. Completion pancreatectomy (CP) was usually performed during reexploration for the complication. The management could decrease the complications, such as the pancreatic leakage or intraluminal infection after reexploration, but could increase mortality during the perioperative period. It also could result in loss of pancreatic function forever. This study evaluated an alternative surgical management for intra-abdominal massive hemorrhage to prevent pancreas function, simplify the surgical processes, and decrease the mortality of relaparotomy. Outcome after pancreaticojejunal bridge-anastomosis (PJBA) performed between January 2006 and June 2009 was compared with that after CP performed between February 1984 and December 2005. Between February 1984 and June 2009, 963 patients underwent the Whipple procedure (PD) or pylorus-preserving pancreaticoduodectomy (PPPD). Pancreatic leakage occurred in 103 patients (10.7%); 22 cases (21.4%) developed into intra-abdominal massive bleeding. Nonsurgical procedures of transarterial embolization (TAE) were performed in ten (45.45%) patients, of whom one died (10%)...Continue Reading

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Citations

Dec 5, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Dario RiberoLorenzo Capussotti
Aug 28, 2012·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Sanjay Govil
Jan 23, 2014·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·U F WellnerT Keck
Feb 12, 2013·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Shailesh V ShrikhandeParul J Shukla
Jun 7, 2019·World Journal of Gastroenterology : WJG·Ya-Tong LiMeng-Hua Dai
Jun 15, 2021·World Journal of Gastrointestinal Surgery·Jian FengYong-Liang Chen
Aug 8, 2021·Updates in Surgery·Roberto SalviaGiovanni Marchegiani

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