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

Detalhes bibliográficos
Autor(a) principal: NARI,Gustavo Adrian
Data de Publicação: 2022
Outros Autores: LOPEZ,Alesio, LAYUN,Jose Luis, MARIOT,Daniela, LOPEZ,Flavia, DE-ELIAS,Maria Eugenia
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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spelling 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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