دورية أكاديمية
أعرض في EDS

Operative Re-Intervention following Pancreatoduodenectomy: What Has Changed over the Last Decades.

التفاصيل البيبلوغرافية
العنوان: Operative Re-Intervention following Pancreatoduodenectomy: What Has Changed over the Last Decades.
المؤلفون: Enderes J; Department of Surgery, University Hospital Bonn, 53127 Bonn, Germany., Pillny C; Department of Surgery, University Hospital Bonn, 53127 Bonn, Germany., Standop J; Department of Surgery, DRK-Hospital Neuwied, 56564 Neuwied, Germany., Manekeller S; Department of Surgery, University Hospital Bonn, 53127 Bonn, Germany., Kalff JC; Department of Surgery, University Hospital Bonn, 53127 Bonn, Germany., Glowka TR; Department of Surgery, University Hospital Bonn, 53127 Bonn, Germany.
المصدر: Journal of clinical medicine [J Clin Med] 2022 Dec 19; Vol. 11 (24). Date of Electronic Publication: 2022 Dec 19.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Basel, Switzerland : MDPI AG, [2012]-
مستخلص: Background: To investigate changes over the last decades in the management of postoperative complications following pancreatoduodenectomy (PD) with special emphasis on reoperations, their indications, and outcomes. Methods: 409 patients who underwent PD between 2008 and 2021 were retrospectively analyzed with respect to their need for reoperations (reoperation, n = 81, 19.8% vs. no reoperation, n = 328, 80.2%). The cohort was then compared to a second cohort comprising patients who underwent PD between 1989 and 2007 (n = 285). Results: 81 patients (19.8%) underwent reoperation. The main cause of reoperation was the dehiscence of pancreatogastrostomy (22.2%). Reoperation was associated with a longer duration of the index operation, more blood loss, and more erythrocyte concentrates being transfused. Patients who underwent reoperation showed more postoperative complications and a higher mortality rate (25% vs. 2%, p < 0.001). Compared to the earlier cohort, the observed increase in reoperations did not lead to increased mortality (5% vs. 6%, p = 353). Conclusions: The main cause for reoperation has changed over the last decades and was the dehiscence of pancreatogastrostomy. Associated with a leakage of pancreatic fluid and clinically relevant PF, it remains the most devastating complication following PD. Strategies for prevention and treatment, e.g., by endoscopic vacuum-assisted-closure therapy are of utmost importance.
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فهرسة مساهمة: Keywords: operative reintervention; pancreatic fistula; pancreatoduodenectomy; redo surgery; reoperation; whipple
تواريخ الأحداث: Date Created: 20221223 Latest Revision: 20230308
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9782126
DOI: 10.3390/jcm11247512
PMID: 36556127
قاعدة البيانات: MEDLINE
الوصف
تدمد:2077-0383
DOI:10.3390/jcm11247512