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Acute Pancreatitis as an Early Complication after Gastric Resection

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Merenda M., Janczak D., Cianciara J., Litarski A.
Polish Journal of Surgery
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2010
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vol. 82
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issue 12
645-650
EN
The aim of the study was to demonstrate acute pancreatitis (AP) as an early complication after gastric resection procedures.Material and methods. Medical records were analyzed for acute pancreatitis as an early postoperative complication in patients treated in Department of Surgery of 4th Military Clinical Hospital in Wrocław between January 2000 and December 2009 who underwent gastric resection procedures. Indications for the surgical treatment included both gastric malignancy as well as complications of gastric and duodenal ulcer disease: pyloric stenosis, bleeding ulcer.Results. Between 2000 and 2009, 123 patients underwent gastric resection procedures (104 due to malignancy, 19 due to complications of gastric and duodenal ulcer disease). The overall complication rate was 32.5%: 26 patients developed general complications (cardiorespiratory failure, cardiac arrhythmias, pleural effusion, psychosis), 10 patients developed abdominal complications (fistula of the anastomosis, pancreatic fistula), infection of the postoperative wound occurred in 6 patients. Perioperative death occurred in 8 patients (mortality rate: 6.5%), including 3 patients who underwent surgical treatment in an urgent setting due to bleeding with accompanying hemorrhagic shock. Acute pancreatitis occurred in four patients (3.25%): all cases were severe and required resection of necrotic pancreatic lesions. The disorder resolved in three cases and patients were discharged home; one patient who developed additional complications, died (mortality rate: 25%).Conclusions. The reported cases of acute pancreatitis after gastric resections procedures were severe, involved pancreatic nacrosis and abscesses and required surgical intervention. Postoperative AP carries high risk of death and its successful treatment depends on properly timed surgical intervention resulting in removal of necrotic pancreatic lesions along with intensive medical treatment using e.g. parenteral nutrition and aggressive antibiotic therapy.
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The role of laparoscopic staging for the management of gastric cancer

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Yüksel C., Erşen O., ilksen b. s., ümit m., ömer y., Culcu S., Bakırarar B., Bayar S., Ünal A. E., Demirci S.
Polish Journal of Surgery
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2021
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vol. 93
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issue 2
1-8
EN
AİM Staging laparoscopy enables us to perform palliative treatment, neo-adjuvant therapy for curative resection or direct curative resection and making a decision with minimal morbidity by avoiding from unnecessary laparotomies. In the present study, the importance of staging lapafoscopy was retrospectively investigated by using clinical and pathologic data. METHODS Data of 70 out of 350 patients who underwent diagnostic laparoscopy due to gastric cancer at Surgical Oncology department between August 2013 and January 2020 were retrospectively analyzed. RESULTS Peritoneal biopsy was positive for malignity in 41 (58.5%) and negative in 29 (41.5%) of the patients who underwent SL. Peritoneal cytology (PC) results were negative in 32 (45.7%) patients and positive in 38 (54.3%) patients. Peritoneal biopsy and cytology results were concurrently positive in 35 patients and concurrently negative in 26 patients. CONCLUSİONS In conclusion, even the most developed imaging methods cannot provide 100% staging, therefore SL plays an important role in treatment of gastric cancer and laparoscopic staging is essential as a simple, inexpensive, safe and well tolerated method in patients who have the suspicion of peritoneal disease and who cannot be clearly evaluated with pre-operative methods.
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Double Tract Reconstruction (DTR) - An Alternative Type of Digestive Tract Reconstructive Procedure After Total Gastrectomy - Own Experience

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Bandurski R., Gryko M., Kamocki Z., Okulczyk B., Zaręba K., Piotrowski Z., Kędra B.
Polish Journal of Surgery
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2011
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vol. 83
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issue 2
70-75
EN
The only proven, effective therapy in case of the gastric cancers is surgery.The aim of the study. The most common procedure which is made in such a situation is total resection of the stomach. In our publication we would like to present and to recommend a very rare made type of the reconstructive procedures after total gastrectomy, which is called "double tract reconstruction" (DTR). This type of reconstruction is occasionally made mainly in Japan.Material and methods. Double tract reconstruction has been made in 2nd Department of General and Gastroenterological Surgery since 2000. Till today 75 patients were treated with this method.Results. The frequency of complications after double tract reconstruction was occasional, and there were no differences between this procedure and Roux-en-Y method of the reconstruction. There were no differences in the time of the operation between this two methods. The most important advantage of this method is that duodenal passage is extant. Because of that the endoscopic examination of papilla Vateri can be made.Conclusions. We would like to recommend this method as an alternative to Roux-en-Y procedure because of its simplicity and safeness.
4
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The Influence of Splenectomy Performed Simultaneously with Gastrectomy on Postoperative Complications in Patients with Gastric Cancer Undergoing Surgery with the Intention to Treat

88%
Głuszek S., Kot M., Kuchinka J., Matykiewicz J.
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vol. 86
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issue 7
312-318
EN
Despite the growing understanding of the pathophysiological processes in the perioperative period and significant advancements in surgical techniques, operative treatment for gastric cancer remains a challenge for surgeons, especially because the primary procedure of total or nearly total gastrectomy must at times be extended by the resection of other organs. The aim of the study was to asses the influence of concomitant splenectomy in patients undergoing curative surgery for gastric cancer on postoperative complications. Material and methods. The study population consisted of 258 patients who underwent surgical treatment for gastric cancer with the intention to treat. The study assessed the influence of extending the surgical intervention by splenectomy on postoperative complications, both general and surgical, including the most severe of these, i.e. oesophago-gastric anastomotic leakage, duodenal stump leakage and peritoneal fluid infections. Results. Among the 258 gastric cancer patients receiving curative surgical treatment, the most common simultaneous intervention was splenectomy: 42/258 (16.3%), which was also accompanied by partial pancreatectomy in 8 cases. The number of surgical postoperative complications, major and minor, was similar in both subgroups: with and without splenectomy. Minor general complications, such as pyrexia with no clinically apparent reason, atelectasis, pneumonia and pleural effusion were statistically significantly more common in the subgroup with splenectomy (p=0.0001). Conclusion. Splenectomy performed concomitantly with gastrectomy for gastric cancer increases the risk of minor general complications. However, it does not increase the risk of severe surgical complications, such as oesophago-intestinal anastomotic leakage and does not increase the risk of death
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