Experience of the prevention and treatment of serious postoperative complications of pancreaticoduo-denectomy

Abstract

Objective To Summarize the experience in prevention and treatment of serious postoperative complications of pancreaticoduodenectomy(PD). Methods A retrospective analysis of 132 patients who suffered PD from January 1997 to October 2009 was carried out. Ninety-one cases were performed with traditional PD and one case association with portal vein partial resection, Twenty-five cases underwent pylorus-preserving PD(PPPD), 16 cases underwent preserving pylorus and ascending part of duodenum PD, and 28 cases underwent binding pancreaticojejunostomy. Results Total postoperative complications of PD was 13.6%, which included: 2 cases of pancreatic fistula(1.52%), 1 case of multiple system organ failure(0.76%), 3 cases of anastomotic stoma bleeding(2.27%), 2 cases of biliary fistula(1.52%), 6 cases of wound infection, 2 cases of gastric emptying block, 1 case of pulmonary infection, 1 case of peritoneal abscess, respectively. Conclusions Pancreatic duct endoprosthesis and T tube drain are the key approaches to prevent severe postoperative complications of PD. Handling bleeding, pancreatic fistula and biliary fistula effectively and promptly can maximally decrease perioperative mortality. Key words: Pancreaticoduodenectomy; Complication; Prevention