IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100403 |
Resumo: | ABSTRACT - BACKGROUND: Several methods have been proposed for the reconstruction of digestive transit after pancreatoduodenectomy. Biliary anastomosis positioned before gastric anastomosis helps reduce postoperative reflux and cholangitis. AIMS: The objective of this study was to present the anatomical sequence of gastric and biliary continuity after pancreatoduodenectomy in patients with pancreatic tumor and to evaluate the short- and long-term results in an initial series of cases. METHODS: Two techniques were used: one with Roux-en-Y reconstruction and pancreaticojejunostomy and the other with a single jejunal loop and pancreatogastroanastomosis. In both the cases, the gastric anastomosis was placed performed before the biliary one. An analysis of demographic data, Wirsung’s duct and common bile duct dilatation, the use of percutaneous drainage, and postoperative complications was carried out. RESULTS: A total of seven patients (four men and three women), with a mean age of 62 years, underwent surgery. All cases had Wirsung’s duct and common bile duct dilatation. A percutaneous external biliary drainage was performed in four patients. There were three postoperative complications: one related to delayed gastric emptying and two related to wound infections. During a median follow-up of 12 months, no episode of cholangitis was recorded. CONCLUSIONS: Elevated percentages of cholangitis are reported in different reconstructions after pancreatoduodenectomy, and it is difficult to conclude reflux as the main etiology. The proposed gastric and biliary reconstructions show conforming results, facilitating posterior endoscopic access. Late follow-up and large number of cases may help assess whether the etiology of postoperative cholangitis is reflux or other factors unrelated to the order of the anastomoses. |
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IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTSPancreatoduodenectomyPostoperative ComplicationsCholangitisAnastomosis, SurgicalABSTRACT - BACKGROUND: Several methods have been proposed for the reconstruction of digestive transit after pancreatoduodenectomy. Biliary anastomosis positioned before gastric anastomosis helps reduce postoperative reflux and cholangitis. AIMS: The objective of this study was to present the anatomical sequence of gastric and biliary continuity after pancreatoduodenectomy in patients with pancreatic tumor and to evaluate the short- and long-term results in an initial series of cases. METHODS: Two techniques were used: one with Roux-en-Y reconstruction and pancreaticojejunostomy and the other with a single jejunal loop and pancreatogastroanastomosis. In both the cases, the gastric anastomosis was placed performed before the biliary one. An analysis of demographic data, Wirsung’s duct and common bile duct dilatation, the use of percutaneous drainage, and postoperative complications was carried out. RESULTS: A total of seven patients (four men and three women), with a mean age of 62 years, underwent surgery. All cases had Wirsung’s duct and common bile duct dilatation. A percutaneous external biliary drainage was performed in four patients. There were three postoperative complications: one related to delayed gastric emptying and two related to wound infections. During a median follow-up of 12 months, no episode of cholangitis was recorded. CONCLUSIONS: Elevated percentages of cholangitis are reported in different reconstructions after pancreatoduodenectomy, and it is difficult to conclude reflux as the main etiology. The proposed gastric and biliary reconstructions show conforming results, facilitating posterior endoscopic access. Late follow-up and large number of cases may help assess whether the etiology of postoperative cholangitis is reflux or other factors unrelated to the order of the anastomoses.Colégio Brasileiro de Cirurgia Digestiva2022-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100403ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.35 2022reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD)instacron:CBCD10.1590/0102-672020220002e1688info:eu-repo/semantics/openAccessNARI,Gustavo AdrianLOPEZ,AlesioLAYUN,Jose LuisMARIOT,DanielaLOPEZ,FlaviaDE-ELIAS,Maria Eugeniaeng2022-09-12T00:00:00Zoai:scielo:S0102-67202022000100403Revistahttp://abarriguda.org.br/revista/index.php/revistaabarrigudaarepb/indexONGhttps://old.scielo.br/oai/scielo-oai.php||revistaabcd@gmail.com2317-63262317-6326opendoar:2022-09-12T00:00ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD)false |
dc.title.none.fl_str_mv |
IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS |
title |
IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS |
spellingShingle |
IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS NARI,Gustavo Adrian Pancreatoduodenectomy Postoperative Complications Cholangitis Anastomosis, Surgical |
title_short |
IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS |
title_full |
IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS |
title_fullStr |
IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS |
title_full_unstemmed |
IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS |
title_sort |
IS THE ANATOMICAL SEQUENCE OF GASTRIC AND BILIARY ANASTOMOSIS IN THE PANCREATODUODENECTOMY RECONSTRUCTION THE CAUSE OF AN INCREASE IN THE INCIDENCE OF CHOLANGITIS? A TECHNICAL VARIANT PRESENTATION AND INITIAL RESULTS |
author |
NARI,Gustavo Adrian |
author_facet |
NARI,Gustavo Adrian LOPEZ,Alesio LAYUN,Jose Luis MARIOT,Daniela LOPEZ,Flavia DE-ELIAS,Maria Eugenia |
author_role |
author |
author2 |
LOPEZ,Alesio LAYUN,Jose Luis MARIOT,Daniela LOPEZ,Flavia DE-ELIAS,Maria Eugenia |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
NARI,Gustavo Adrian LOPEZ,Alesio LAYUN,Jose Luis MARIOT,Daniela LOPEZ,Flavia DE-ELIAS,Maria Eugenia |
dc.subject.por.fl_str_mv |
Pancreatoduodenectomy Postoperative Complications Cholangitis Anastomosis, Surgical |
topic |
Pancreatoduodenectomy Postoperative Complications Cholangitis Anastomosis, Surgical |
description |
ABSTRACT - BACKGROUND: Several methods have been proposed for the reconstruction of digestive transit after pancreatoduodenectomy. Biliary anastomosis positioned before gastric anastomosis helps reduce postoperative reflux and cholangitis. AIMS: The objective of this study was to present the anatomical sequence of gastric and biliary continuity after pancreatoduodenectomy in patients with pancreatic tumor and to evaluate the short- and long-term results in an initial series of cases. METHODS: Two techniques were used: one with Roux-en-Y reconstruction and pancreaticojejunostomy and the other with a single jejunal loop and pancreatogastroanastomosis. In both the cases, the gastric anastomosis was placed performed before the biliary one. An analysis of demographic data, Wirsung’s duct and common bile duct dilatation, the use of percutaneous drainage, and postoperative complications was carried out. RESULTS: A total of seven patients (four men and three women), with a mean age of 62 years, underwent surgery. All cases had Wirsung’s duct and common bile duct dilatation. A percutaneous external biliary drainage was performed in four patients. There were three postoperative complications: one related to delayed gastric emptying and two related to wound infections. During a median follow-up of 12 months, no episode of cholangitis was recorded. CONCLUSIONS: Elevated percentages of cholangitis are reported in different reconstructions after pancreatoduodenectomy, and it is difficult to conclude reflux as the main etiology. The proposed gastric and biliary reconstructions show conforming results, facilitating posterior endoscopic access. Late follow-up and large number of cases may help assess whether the etiology of postoperative cholangitis is reflux or other factors unrelated to the order of the anastomoses. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100403 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100403 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0102-672020220002e1688 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgia Digestiva |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgia Digestiva |
dc.source.none.fl_str_mv |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.35 2022 reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD) instacron:CBCD |
instname_str |
Colégio Brasileiro de Cirurgia Digestiva (CBCD) |
instacron_str |
CBCD |
institution |
CBCD |
reponame_str |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
collection |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
repository.name.fl_str_mv |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD) |
repository.mail.fl_str_mv |
||revistaabcd@gmail.com |
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1754208959590301696 |