External Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique

Background: Postoperative pancreatic fistula (POPF) is a major cause of morbidity after pancreaticoduodenectomy. There is no consensus on the best technique to protect the pancreato-enteric anastomosis and reduce the rate of POPF. This study investigated the feasibility and efficiency of external su...

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Autores principales:	H. C. Albrecht, C. Amling, C. Menenakos, S. Gretschel
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	pancreaticoduodenectomy pancreatogastrostomy postoperative pancreatic fistula pancreas duct drainage soft pancreas Surgery RD1-811
Acceso en línea:	https://doaj.org/article/a25be6b509354ef2afaced8d1e8ec5bd
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spelling	oai:doaj.org-article:a25be6b509354ef2afaced8d1e8ec5bd2021-11-17T04:48:05ZExternal Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique2296-875X10.3389/fsurg.2021.754288https://doaj.org/article/a25be6b509354ef2afaced8d1e8ec5bd2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.754288/fullhttps://doaj.org/toc/2296-875XBackground: Postoperative pancreatic fistula (POPF) is a major cause of morbidity after pancreaticoduodenectomy. There is no consensus on the best technique to protect the pancreato-enteric anastomosis and reduce the rate of POPF. This study investigated the feasibility and efficiency of external suction drainage of the pancreatic duct to improve the healing of pancreaticogastrostomy.Methods: Between July 2019 and June 2021, 21 consecutive patients undergoing elective pancreaticoduodenectomy were included. In all patients we performed a pancreaticogastrostomy and inserted a negative pressure drainage into the pancreatic duct. The length and diameter of the pancreatic duct were measured and the texture of the pancreas was evaluated. The daily secretion volume and the lipase value via pancreatic duct drainage were documented. The occurrence of POPF was evaluated.Results: None of the patients had drainage-related complications. In 4 patients we registered a dislocation of the drainage from the pancreas duct into the stomach. 17/21 Patients showed no signs of POPF. A biochemical leak was measured in one patient. Furthermore, 2 patients had a POPF grade B. In one patient, POPF grade C required reoperation and resection of the remnant pancreas. All 4 cases of POPF met the risk criteria soft pancreas, high volume and high lipase value in the duct drainage.Conclusion: The insertion of the pancreatic duct drainage was feasible and caused no drainage-related morbidity. POPF-rate was moderate in the risk population of soft pancreas and small duct.H. C. AlbrechtC. AmlingC. MenenakosS. GretschelFrontiers Media S.A.articlepancreaticoduodenectomypancreatogastrostomypostoperative pancreatic fistulapancreas duct drainagesoft pancreasSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pancreaticoduodenectomy pancreatogastrostomy postoperative pancreatic fistula pancreas duct drainage soft pancreas Surgery RD1-811
spellingShingle	pancreaticoduodenectomy pancreatogastrostomy postoperative pancreatic fistula pancreas duct drainage soft pancreas Surgery RD1-811 H. C. Albrecht C. Amling C. Menenakos S. Gretschel External Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique
description	Background: Postoperative pancreatic fistula (POPF) is a major cause of morbidity after pancreaticoduodenectomy. There is no consensus on the best technique to protect the pancreato-enteric anastomosis and reduce the rate of POPF. This study investigated the feasibility and efficiency of external suction drainage of the pancreatic duct to improve the healing of pancreaticogastrostomy.Methods: Between July 2019 and June 2021, 21 consecutive patients undergoing elective pancreaticoduodenectomy were included. In all patients we performed a pancreaticogastrostomy and inserted a negative pressure drainage into the pancreatic duct. The length and diameter of the pancreatic duct were measured and the texture of the pancreas was evaluated. The daily secretion volume and the lipase value via pancreatic duct drainage were documented. The occurrence of POPF was evaluated.Results: None of the patients had drainage-related complications. In 4 patients we registered a dislocation of the drainage from the pancreas duct into the stomach. 17/21 Patients showed no signs of POPF. A biochemical leak was measured in one patient. Furthermore, 2 patients had a POPF grade B. In one patient, POPF grade C required reoperation and resection of the remnant pancreas. All 4 cases of POPF met the risk criteria soft pancreas, high volume and high lipase value in the duct drainage.Conclusion: The insertion of the pancreatic duct drainage was feasible and caused no drainage-related morbidity. POPF-rate was moderate in the risk population of soft pancreas and small duct.
format	article
author	H. C. Albrecht C. Amling C. Menenakos S. Gretschel
author_facet	H. C. Albrecht C. Amling C. Menenakos S. Gretschel
author_sort	H. C. Albrecht
title	External Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique
title_short	External Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique
title_full	External Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique
title_fullStr	External Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique
title_full_unstemmed	External Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique
title_sort	external negative pressure drainage of the pancreatic duct in pancreatogastrostomy following pylorus-preserving pancreaticoduodenectomy—feasibility and technique
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a25be6b509354ef2afaced8d1e8ec5bd
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External Negative Pressure Drainage of the Pancreatic Duct in Pancreatogastrostomy Following Pylorus-Preserving Pancreaticoduodenectomy—Feasibility and Technique

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