Comparison of Early Results of Surgical Treatment in Patients with Pancreatic Cancer

• Authors: Jacek Śmigielski , Łukasz Piskorz , Leszek Kutwin , Marian Brocki
• Languages of publication: EN

Abstracts

EN

Pancreatic tumours are a serious medical and social issue. Patients come to the doctor too late, when the disease is well advanced. The most frequently applied method of surgical treatment is pancreatoduodenectomy (Whipple procedure). The most frequently used technique of pancreatoduodenectomy is the Child-Waugh method. The procedure can be performed in a classic way or as modified by Traverso (with preservation of the pylorus).Material and methods. Between August 2008 and June 2011, in the Department of Thoracic, General and Oncologic Surgery of Medical University in Łódź, a total of 79 patients with pancreatic tumours were hospitalized. In 61, pancreatoduodenectomy was performed. The patients were divided into two groups, depending on the diagnosis and the procedures performed: group 1 comprised patients in whom the pylorus was resected (n = 43); group 2 comprised patients in whom the pylorus was preserved (Traverso-Longmire procedure; n = 18).Results. Mean duration of surgery was about 3 hours and 50 minutes in both groups. Mean duration of hospitalization after the procedure was 15.6 days in group 1 and 12.2 days in group 2 (p < 0.05). Early complications (within 30 days of the procedure) were observed in 33.2% of patients in both groups. Blood transfusion was necessary in 21% of patients in group 1 and 28% of patients in group 2 (p>0.05).Conclusions. There are specific indications for each method of surgical treatment, however, it seems that both techniques of pancreatic resection can be recommended as standard surgical treatment, and the number of complications after both procedures is similar.

Keywords

EN

pancreatic cancer; complications; Kausch-Whipple procedure; Traverso-Longmire procedure

• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 1
• Pages: 1-5

Dates

published

1 - 1 - 2012

online

3 - 4 - 2012

Contributors

author

Jacek Śmigielski

• Department of Thoracic, General and Oncologic Surgery, Medical University in Łódź

author

Łukasz Piskorz

• Department of Thoracic, General and Oncologic Surgery, Medical University in Łódź

author

Leszek Kutwin

• Department of Thoracic, General and Oncologic Surgery, Medical University in Łódź

author

Marian Brocki

• Department of Thoracic, General and Oncologic Surgery, Medical University in Łódź

References

• Kachocka I: Objawy, rozpoznanie i leczenie chorób dróg żółciowych opisane na łamach "Przeglądu Chirurgicznego" (1893-1905). Pol Przegl Chir 2006; 12: 1530-1545
• Popiela T, Drews M, Jeziorski A i wsp.: Nowotwory żołądka, brodawki Vatera, jelita cienkiego, trzustki, wątroby, przewodów żółciowych i pęcherzyka żółciowego. Wydawnictwo Via Medica 2009.
• Cichocki A, Jóżwiak M, Samsel R i wsp.: Charakterystyka guzów trzustki i pola trzustkowodwunastniczego w materiale własnym w prospektywnej obserwacji 2-letniej. Pol Przegl Chir 2008;5: 415-27
• Lampe P, Kuśnierz K: Uwagi dotyczące wybranych problemów chirurgii trzustki. Pol Przegl Chir 2008; 6: 527-532
• Ji J, Forsti A, Sundquist J et al.: Przeżycie w rodzinnym raku trzustki. Pancreatology 2008; 8: 252-256[Crossref]
• Noszczyk W: Chirurgia. Wydawnictwo Lekarskie PZWL, Warszawa 2006.
• Zhu B, Geng L, Ma YG et al.: Combined invagination and duct-to-mucosa techniques with modifications: a new method of pancreaticojejunal anastomosis. Hepatobiliary Pancreat Dis Int 2011 Aug; 10(4): 422-27.
• Ramacciato G, Mercantini P, Petrucciani N et al.: Risk factors of pancreatic fistula after pancreaticoduodenectomy: a collective review. Am Surg 2011 Mar; 77(3): 257-69.
• Reichman TW, Anthony T, Testa G: Treatment of extrahepatic portal hypertension following a whipple procedure with a Rex shunt: report of a case. Surg Today 2011 Feb; 41(2): 292-96.[WoS][PubMed][Crossref]
• Mishra PK, Saluja SS, Gupta M et al.: Blumgart's Technique of Pancreaticojejunostomy: An Appraisal. Dig Surg 2011 Jul 29; 28(4): 281-87.[WoS]
• Gangavatiker R, Pal S, Javed A et al.: Effect of antecolic or retrocolic reconstruction of the gastro/duodenojejunostomy on delayed gastric emptying after pancreaticoduodenectomy: a randomized controlled trial. J Gastrointest Surg 2011 May; 15(5): 843-52.[WoS][Crossref]
• Plaszczyk-Lesiakowska D, Krawczyk M: Czynniki ryzyka powikłań pankreatoduodenektomii. Pol Przegl Chir 2001, 6: 756-61.
• Marquez S, Marquez TT, Ikramuddin S et al.: Laparoscopic and da Vinci robot-assisted total pancreaticoduodenectomy and intraportal islet autotransplantation: case report of a definitive minimally invasive treatment of chronic pancreatitis. Pancreas 2010 Oct; 39(7): 1109-11.[WoS][Crossref]
• Al-Taan OS, Stephenson JA, Briggs C et al.: Laparoscopic pancreatic surgery: a review of present results and future prospects. HPB (Oxford) 2010 May; 12(4): 239-43.
• Satyadas T, Kanhere HA, Lauder C et al.: Evolution in technique of laparoscopic pancreaticoduodenectomy: a decade long experience from a tertiary center. J Hepatobiliary Pancreat Sci 2010 May; 17(3): 367-68.[WoS]

Identifiers

DOI

10.2478/v10035-012-0001-8