PANCREATO-DUODENECTOMY OPERATIVE MORTALITY AND POSTOPERATIVE COMPLICATIONS

• Published in: Japanese Journal of National Medical Services Vol. 45; no. 4; pp. 341 - 346
• Main Authors: FURUKAWA, Masato, NAKATA, Toshinori, KUSANO, Toshiomi, WATABE, Seiichiro, OU, Shimei, YAMADA, Masashi, JONO, Hidetoshi, KOGA, Hirotaka, NAGAO, Shuji, HAMAMOTO, Takahiro, ITO, Mieko
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1991
• Subjects: operative mortality; pancreatic duct drainage; pancreatic duct ligation; pancreato-duodenectomy; postoperative complication
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.45.341

Pancreato-duodenectomy (P-D) has been commonly performed as a safe surgical treatment with lowered mortality rate. However, P-D is still one of the time-consuming operations and is also associated with much amount of operative bleeding and complications are not rare. We performed P-D for 53 patients between January 1972 and May 1990, at the Department of Surgery, Nagasaki Chuo National Hospital. Subjects included 15 patients with pancreatic head cancer, 13 with carcinoma of bile duct, 10 with carcinoma of papilla of Vater, 2 with chronic pancreatitis or other deseases. This is a report on the results of clinical investigation of these cases. No operative death occurred. Complications associated with pancreato-jejunostomy (P-J) were pancreatic fistula in one patient, and transient leakage of pancreatic fluid in one patient. These two complicatins were mitigated by conservative treatment. We were able to avoid the major complications of P-J by emplacing a pancreatic duct drain in all patients. It is suggested that these securing pancreatic drainage may be responsible for no operative death in these cases. Additionally, pancreatic duct ligation without P-J may result in diminished digestive and absorptive function. This procedure should therefore not be performed in cases where substantial longevity is possible.