Prevention and treatment of postoperative complications of duodenum preserving pancreatic head resection

Abstract

Objective To investigate the approach for prevention and treatment of postoperative complications of the duodenum-preserving pancreatic head resection (DPPHR). Method The clinical data of 56 patients receiving DPPHR in our hospital from 2003 to 2008 were retrospectively analyzed. Results Thirteen (23.3%) of the 56 patients had complications after DPPHR. The complications were pancreatic fistula in 7 cases (12.5%), duodenal fistula in 2 (5.4%) and biliary fistula in 1 (2.8%) and they were healed by supportive treatment and unobstructed drainage. Three cases (2.2%) of retroperitoneal infection were treated by putting drainage tube under ultrasonic guidance, 1 case (2.8%) with abdominal hemorrhage was disclosed to rupture and bleed in the branch of gastro-duodenal artery by selective celiac arteriography on emergency, and then treated with embolism with gelatin sponge and stainless steel. Conclusion The main complications after DPPHR are pancreatic fistula, duodenal fistula, biliary fistula, abdominal infection and hemorrhage. Meticulous operative technique, strict prehension of operation indications and complete reservation of blood supply of duo-denum are the key points to reduce postoperative complications and morbidity and increase operative a-chievement ratio after DPPHR. Meanwhile, correct methods should be used upon finding the compli-cations. Key words: Pancreatetomy; Postoperative complication