Post-operative Complication after Pancreaticoduodenectomy Identification of a High Risk Group for Cholangitis and its Management

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 31; no. 8; pp. 1850 - 1856
• Main Authors: Ishida, Hidefumi, Yamamoto, Masahiro, Ohashi, Osamu, Fujiwara, Hidetoshi, Onoyama, Hirohiko, Kuroda, Yoshikazu, Sakamoto, Setsu, Yamasaki, Katsuhito, Kono, Michio, Matsui, Mieko
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1998
• Subjects: biliary scintigraphy; pancreaticoduodenectomy; postoperative cholangitis; quality of life; serum alkaline phosphatase
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.31.1850

Long term outcome in 35 patients after pancreaticoduodenectomy (PD) was studied from the viewpoints of cholangitis and social rehabilitation, by means of serum markers, image findings and clinical symptoms. Cholangitis was observed postoperatively in 5 patients (14.3%), all of whom had undergone the PD-II procedure; the causes of postoperative cholangitis appeared to be bile stasis at the hepatohilar region or in the manipulated jejunal loop. In the patients who developed cholangitis, serum alkaline phosphatase (ALP) levels were elevated and unstable and bile stasis detected by biliary scintigraphy; clinical signs of cholangitis did not occur. To improve long term outcome after PD, it is important to identify patients with a high risk of cholangitis using these findings and to counsel them to modify their lifestyle. Four of 5 patients with cholangitis were able to achieve social rehabilitation to some extent and maintain an excellent quality of life (QOL) by avoiding recurrence of cholangitis.