췌두부십이지장절제술 후 Synthetic Somatostatin과 췌액의 외부 배액이 합병증 예방에 미치는 영향

• Published in: Annals of surgical treatment and research Vol. 64; no. 5; pp. 418 - 422
• Main Authors: 이태희(Tae Hee Lee), 권정남(Jeong Nam Kwon), 박동은(Dong Eun Park), 소병준(Byung Jun So), 채권묵(Kwon Mook Chae)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.05.2003
• Subjects: 일반외과학
• ISSN: 2288-6575; 2288-6796

Purpose: A pancreatic fistula is the most dreaded complication following a pancreaticoduodenenctomy, and various methods have been used to for its prevention. This study was designed to evaluate the role of external tube drainage of the pancreatic duct, and the use of octreotide in preventing complications following a pancreaticoduodenectomy. Methods: 137 patients (82 men, 55 women; mean age 63.3 years) diagnosed with either a periampullary cancer (115), chronic pancreatitis (13), or trauma (9) and who had undergone a pancreaticoduodenectomy (classic Whipples' operation (78), PPPD (59)) were evaluated. The patients were divided into 3 groups; Group A (n=31): with externally drained pancreatic juice, but with out the use of octreotide, Group B (n=56): with externally drained pancreatic juice, and the used of octreotide, and Group C (n=50): with the used of octreotide only with no external tube drainage. Results: The morbidity and mortality were 38/137 (28%) and 2/137 (1.5%), respectively. A pancreatic fistula developed in 7 cases (5%), but no statistically significant differences were shown between the groups. The levels of serum amylase on the 1st, 3rd, 5th and 7th postoperative days were lower in groups B and C, those using octreotide (P＜0.01). The level of amylase in the drain fluid were also lower in groups B and C on the 7th day (P＜0.01). Group C had the lowest amylase levels in both the serum and drain fluid. Conclusion: The external drainage of pancreatic juice is considered to be of little significance in preventing complications following a pancreaticoduodenectomy, but the postoperative use of octreotide is helpful in preventing complications due to the prevention of postoperative pancreatic sweating. (J Korean Surg Soc 2003;64:418-422) KCI Citation Count: 0