TITLE

Reoperative Surgery for Chronic Pancreatitis: Is It Safe?

AUTHOR(S)
Schnelldorfer, Thomas; Lewin, David; Adams, David
PUB. DATE
July 2006
SOURCE
World Journal of Surgery;Jul2006, Vol. 30 Issue 7, p1321
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: Eleven percent to fifty-six percent of patients do not achieve adequate pain relief with initial operative treatment for chronic pancreatitis, and reoperations for recurrent or persistent pain are common. This study evaluates the influence of prior pancreatic procedures on operative morbidity for chronic pancreatitis. Methods: The records of 336 consecutive patients who underwent pancreaticoduodenectomy (PD, n = 78), lateral pancreaticojejunostomy (LPJ, n = 152), distal pancreatectomy (DP, n = 83), transduodenal sphincteroplasty (SP, n = 20), and total pancreatectomy (TP, n = 3) for chronic pancreatitis were retrospectively reviewed and analyzed. Results: Seventy-four patients underwent reoperation after failed prior pancreatic surgery. Patients with de novo pancreatic operations had a similar complication rate as those with reoperation (PD: 48% versus 65%, P > 0.05; LPJ: 23% versus 23%, P > 0.05; DP: 26% versus 28%, P > 0.05; SP: 21% versus 100%, P > 0.05). Major complications such as pancreatic leak or abdominal abscess were similar in the two groups. Minor complications such as delayed gastric emptying or wound infections were more common in the reoperation group. There was no difference in postoperative hospital length of stay. Conclusions: Patients who undergo reoperative surgery for chronic pancreatitis have an increased risk for minor perioperative complications. The overall complication rate and the incidence of major complications are similar compared to de novo procedure. Reoperative surgery therefore appears feasible and safe in experienced hands.
ACCESSION #
21553382

 

Related Articles

  • Surgical revision of hepaticojejunostomy strictures after pancreatectomy. Prawdzik, Christopher; Belyaev, Orlin; Chromik, Ansgar; Uhl, Waldemar; Herzog, Torsten // Langenbeck's Archives of Surgery;Jan2015, Vol. 400 Issue 1, p67 

    Background: After pancreatic surgery hepaticojejunostomy (HJ) stricture is a rare condition. Usually, management is conservative, while operative revision ('redo') is only rarely performed. Methods: This was an observational cohort design that analyzed the outcome of patients who had a surgical...

  • Central pancreatectomy with pancreaticogastrostomy for benign pancreatic pathology Efron, David T.; Lillemoe, Keith D.; Cameron, John L.; Yeo, Charles J. // Journal of Gastrointestinal Surgery;Jul2004, Vol. 8 Issue 5, p532 

    Benign lesions of the neck and proximal body of the pancreas pose an interesting surgical challenge. If the lesions are not amenable to simple enucleation, surgeons may be faced with the choice of performing a right-sided resection (pancreaticoduodenectomy) or a left-sided resection (distal...

  • Reconsideration of Delayed Gastric Emptying in Pancreaticoduodenectomy. Yan-Shen Shan; Mei-Ling Tsai; Nan-Tsing Chiu; Pin-Wen Lin // World Journal of Surgery;Jul2005, Vol. 29 Issue 7, p873 

    Literature reports indicate that the incidence of delayed gastric emptying (DGE) is higher after pylorus-preserving pancreaticoduodenectomy (PPPD) than after conventional pancreaticoduodenectomy (CPD), but DGE is traditionally diagnosed from patient-reported subjective sensations. Our clinical...

  • Pancreatic Anastomoses after Pancreaticoduodenectomy: Do We Need Further Studies? Shrikhande, Shailesh; Qureshi, Sajid; Rajneesh, Nanda; Shukla, Parul // World Journal of Surgery;Dec2005, Vol. 29 Issue 12, p1642 

    Pancreatic anastomotic leak is the single most important factor responsible for the considerable morbidity and mortality associated with pancreaticoduodenectomy. Management of the pancreatic remnant is controversially discussed, reflecting the complexity of anastomosing a pancreas of different...

  • Whipple's operation. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p805 

    An encyclopedia entry for "Whipple's operation" is presented. It refers to a type of pancreatectomy in which the head of the pancreas and the loop of the duodenum are surgically removed.

  • Results of a pancreatectomy with a limited venous resection for pancreatic cancer. Giulio Illuminati; Fabio Carboni; Riccardo Lorusso; Antonio D’Urso; Gianluca Ceccanei; Vassilios Papaspyropoulos; Maria Pacile; Eugenio Santoro // Surgery Today;Jun2008, Vol. 38 Issue 6, p517 

    Abstract Purpose  The indications for a pancreatectomy with a partial resection of the portal or superior mesenteric vein for pancreatic cancer, when the vein is involved by the tumor, remain controversial. It can be assumed that when such involvement is not extensive, resection...

  • Pancreatic fistula after pancreatectomy: Evolving definitions, preventive strategies and modern management. Shrikhande, Shailesh V.; D'Souza, Melroy A.; Llado, Laura // World Journal of Gastroenterology;10/14/2008, Vol. 14 Issue 38, p5789 

    Pancreatic resection is the treatment of choice for pancreatic malignancy and certain benign pancreatic disorders. However, pancreatic resection is technically a demanding procedure and whereas mortality after a pancreaticoduodenectomy is currently < 3%-5% in experienced high-volume centers,...

  • Lateral approach in laparoscopic distal pancreatectomy is safe and potentially beneficial compared to the traditional medial approach. Strickland, Matt; Hallet, Julie; Abramowitz, Daniel; Liang, Shuyin; Law, Calvin; Jayaraman, Shiva // Surgical Endoscopy;Sep2015, Vol. 29 Issue 9, p2825 

    Introduction: Laparoscopic distal pancreatectomy has become widely accepted for the treatment of left-sided pancreatic lesions. Traditionally, a medial laparoscopic distal pancreatectomy (MDLP) has been employed, with division of the gland followed by medial to lateral mobilization. Recent...

  • Pancreaticobiliary Drainage by T-tube, A Promising Technique for Prevention of Pancreatic Leakage following Pancreaticoduodenectomy (Whipple Surgery). Tabatabaee, S. A.; Hashemi, S. M.; Fazel, M. R.; Dadkhah, S.; Jazi, A. H. Davarpanah // International Journal of Preventive Medicine;May2012, Vol. 3 Issue 5, p373 

    The article investigates the effectiveness of pancreaticobiliary drainage by T-tube in preventing pancreatic leakage after pancreaticoduodenectomy or Whipple surgery. It states that pancreaticojejunal anastomosis leakage is the most complicated situation after Whipple surgery with a high...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics