Possibility of prognostication for unfavorable results of the pancreaticoduodenal resection on background of the obturation jaundice syndrome

Keywords: prognostication; bilary decompression; pancreaticoduodenal resection; pancreatic gland; obturation jaundice; anastomosis

Abstract

Objective. To determine the possibility of prognostication of unfavorable course of postoperative period in the aspect of the planned pancreaticoduodenal resection for focal affection of pancreaticoduodenal zone on background of obturation jaundice.

Materials and methods. The pancreatic head cancer was verified in 174 (64.0%) patients, cancer of the duodenal papilla magna - in 20 (7.4%), cancer of distal hepaticocholedochus - in 24 (8.8%), chronic pseudotumoral pancreatitis - in 54 (20.0%) patients. In the main group (112 patients) preparation to operative intervention was conducted in accordance to elaborated algorithm, and in a control group (160 patients) - in accordance to conventional standards.

Results. Pancreaticoduodenal resection with formation of termino-lateral anastomosis in accordance to Whipple procedure was performed in 38 (14.0%) patients, termino-terminal anastomosis in accordance to procedure of Shalimov-Kopchak - in 40 (14.7%), ductomucous pancreaticojejunoanastomosis - in 127 (46.7%), pancreaticogastroanastomosis with invagination of the pancreatic stump into the gastric stump - in 35 (12.9%), pancreaticogastrostomy with  deepening of the pancreatic stump into the sleeve, made of the big gastric curvature - in 32 (11.8%). Insufficiency of pancreaticodigestive anastomosis have occurred in 32 (11.8%) patients. Mortality have constituted 5.1%.

Author Biographies

P. T. Muraviov, Odessa National Medical University

Muraviov Petro T. MD, PhD, Ass. Professor,
Department of Surgery 2,
Odessa National Medical University,
Sudostroitelnaya str., 1 Odessa, 65000, Ukraine,
067-752-40-11
gemostatik@mail.ru, surgery2@odmu.edu.ua;
https://orcid.org/0000-0001-7733-885X

B. S. Zaporozhchenko, Odessa National Medical University

Zaporozhchenko Boris S. MD, DSci(Med), Professor,
Department of Surgery 2,
Odessa National Medical University,
Sudostroitelnaya str., 1 Odessa, 65000, Ukraine,
067-487-69-29;
surgery2@odmu.edu.ua;
https://orcid.org/0000-0003-0655-6539

I. E. Borodaev, Odessa National Medical University

Borodaev Igor E., MD, PhD, Ass. Professor,
Department of Surgery 2,
Odessa National Medical University,
Sudostroitelnaya str., 1 Odessa, 65000, Ukraine,
+380672923236;
xir316@gmail.com;
https://orcid.org/0000-0002-0859-2499

V. G. Shevchenko , Odessa National Medical University

Shevchenko Valeriia G. MD, PhD, Ass. Professor,
Department of Surgery 2,
Odessa National Medical University,
Sudostroitelnaya str., 1 Odessa, 65000, Ukraine,
surgery2@odmu.edu.ua
https://orcid.org/0000-0001- 7849- 4897

References

Shulga IV, Macak VA, Vishnevskaja AN. Analiz rezultatov hirurgicheskogo lechenija bolnyh s opuholjami pankreatoduodenal'noj zony. Tihookeanskij medicinskij zhurnal.2013;(3):32-4. [In Russian].

Jareshko VG, Otarashvili KN. Khirurgicheskoe lechenie raka podzheludochnoj zhelezy. Kharkivska khirurgichna shkola. 2015;(4):75-9. [In Russian].

Kutovoj AB, Snisar AV, Peleh VA, Rodinskaja GA, Kutovoj MA, Ljulka VI. Oslozhneniya pankreatoduodenalnoy rezekcii i vozmozhnye puti ih preduprezhdenija. Kharkivska khirurgichna shkola. 2016;(2):38-42. [In Russian].

Lian PL, Chang Y, Xu XC, Zhao Z, Wang X.Q, Xu K.S. Pancreaticoduodenectomy for duodenal papilla carcinoma: A single-centre 9-year retrospective study of 112 patients with long-term follow-up. World J. Gastroenterol. 2017;23(30):5579-88. doi: 10.3748/wjg.v23.i30.5579

Byrlinga J, Anderssona R, Sasorb A, Lindella G, Ansaria D, Nilsson J, et al. Outcome and evaluation of prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma. Ann Gastroenterol. 2017;30:1-7. doi: 10.20524/aog.2017.0169.

Kawakubo K, Tada M, Isayama H, Sasahira N, Nakai Y, Takahara N, et al. Risk for mortality from causes other than pancreatic cancer in patients with intraductal papillary mucinous neoplasm of the pancreas. Pancreas. 2013;42(4):687-91. doi: 10.1097/MPA.0b013e318270ea97.

Baichorov EH, Brusnev LA, Novodvorskiy SA, Baichorov ME, Gridasov IM, Semenov SS, et al. Prognozirovanie posleoperacionnyh gnojno-vospalitel'nyh oslozhnenij pri pankreatoduodenal'noj rezekcii. Medicinskij vestnik Severnogo Kavkaza.2014;(3):231-4. doi: 10.14300/mnnc.2014.09065. [In Russian].

De Carlis L, Ferla F, Di Sandro S, Giacomoni A, De Carlis R, Sguinzi R. Pancreatico-duodenectomy and postoperative pancreatic fistula: risk factors and technical considerations in a specialized HPB center. Updates Surg. 2014;66(2): 145-50. doi: 10.1007/s13304-014-0253-4

Matsumoto M, Nakabayashi Y, Fujiwara Y, Funamizu N, Noaki R, Eto Set al. Duration of Preoperative Biliary Drainage as a Prognostic Factor After Pancreaticoduodenectomy for Pancreatic Head Cancer. Anticancer Res. 2017 Jun;37(6):3215-3219. PMID: 28551667. doi: 10.21873/anticanres.11683.

Published
2019-10-21
How to Cite
Muraviov, P. T., Zaporozhchenko, B. S., Borodaev, I. E., & Shevchenko , V. G. (2019). Possibility of prognostication for unfavorable results of the pancreaticoduodenal resection on background of the obturation jaundice syndrome. Klinicheskaia Khirurgiia, 86(10), 8-11. https://doi.org/10.26779/2522-1396.2019.10.08
Section
General Problems of Surgery