How necessary is vagotomy after pancreaticoduodenectomy and total pancreatectomy.
Hepatogastroenterology
; 52(61): 251-2, 2005.
Article
en En
| MEDLINE
| ID: mdl-15783042
BACKGROUND/AIMS: Gastrectomy with gastrojejunostomy is a fundamental step used for the restoration of the alimentary tract after pancreaticoduodenectomy or total pancreatectomy. Anastomotic ulcers occurring after pancreaticoduodenectomy, is a well known problem. The aim of our study is to investigate the incidence of anastomotic ulcer after pancreaticoduodenectomy or total pancreatectomy and to elucidate whether vagotomy is necessary. METHODOLOGY: In this study we reviewed the medical records of 94 patients who underwent pancreaticoduodenectomy or total pancreatectomy without vagotomy and we report the results after systemic follow-up 3-14 years, emphasizing the cases in which anastomotic ulcer is jeopardized. RESULTS: A total of 78 Whipple procedures and 16 total pancreatectomies without vagotomy were performed. The overall incidence of anastomotic ulceration following pancreatectomy was 11.7%. In our series the symptoms and complications associated with anastomotic ulceration were pain in 6 patients, bleeding in 4 patients and free perforation in one patient. Six patients needed a reoperation, the 4 patients with bleeding that underwent truncal vagotomy, the patient with free perforation in which oversew and bilateral vagotomy was performed and a patient with refractory pain who underwent a bilateral vagotomy. Among the 11 patients with anastomotic ulcer, the overall postoperative mortality rate was 27.3%. CONCLUSIONS: It seems reasonable to perform bilateral truncal vagotomy only in patients with a history of peptic ulceration and for patients with favorable prognosis and potential for long survival.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pancreatectomía
/
Úlcera Péptica
/
Pancreaticoduodenectomía
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Hepatogastroenterology
Año:
2005
Tipo del documento:
Article
País de afiliación:
Grecia
Pais de publicación:
Grecia