Objective To explore the risk factors and treatment associated with postoperative hemorrhage after pancreaticoduodenectomy. Methods The clinical data of 78 patients undergoing pancreatieoduodeneetomy from May 2009 to October 2011 were retrospectively analyzed in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Results The incidence of postoperative hemorrhage was 10.3％ （8/78）. Among these eight patients, intra-abdominal hemorrhage occurred in two cases （one case of early and delayed hemorrhage respectively）, and gastrointestinal hemorrhage occurred in 6 cases （one and five cases of early and delayed hemorrhage respectively）. Univarlate analysis showed that operative blood loss, postoperative celiac infection, pancreatic fistula, and pancreaticogastrostomy were significantly associated with postoperative hemorrhage. Multivariate analysis identified for vailables as independent factors associated with postoperative hemorrhage, namely, pancreaticogastrostomy, postoperative celiac infection, and pancreatic fistula. Conclusions Skillful operation, prevention of pancreatic fistula, and control celiac infection are important for reducing postoperative hemorrhage. Proper treatments should be used according to the site, onset, and severity of hemorrhage. To prevent its occurrence is the key of treatment.
Objective To evaluate the operative indication and results of pancreaticogastrostomy following pancreaticoduodenectomy. Methods A retrospective study was carried out on the cases of pancreaticoduodenectomy following pancreaticogastrostomy from Aug. 2005 to Feb. 2008 in Shanghai Tongji Hospital. Results During this period, 38 cases had undergone pancreaticogastrostomy with pancreaticoduodenectomy. The median operative time was (352.1±78.3) min. The median intraoperative blood transfusion was (911.3±601.4) ml. The median postoperative length of stay was (26.2±12.1) d. Postoperative morbidity was 21.1% (8/38) with no operative death. Pancreatic anastomotic leakage occurred in 1 patient. Delayed gastric emptying occurred in 2 patients. Incision infection occurred in 2 patients. Abdominal fluid collection occurred in 1 patient and pulmonary infection occurred in 2 patients. All of the complications were treated conservatively. Conclusion Pancreaticogastrostomy is a safer drainage procedure for the pancreatic stump after pancreaticoduodenectomy.
ObjectiveTo summarize the application and the complications of pancreaticogastrostomy (PG) after pancreaticoduodenectomy(PD). MethodThe domestic and international publications involving the theory, methods, and clinical application of PG were retrieved and reviewed. ResultsPG was gradually concerned on the choice of the method of the digestive tract reconstruction after PD, in view of its advantages in theory and operation. The literatures about PG were increased in recent years. But the discussion of decreasing complications of PG after PD had yet to be unified. ConclusionsPG is one of the important operations of digestive tract reconstruction after PD. The factors of operator and patient should be comprehensively considered in the choice of PG.