Reoperation after laparoscopic pancreatoduodenectomy: an analysis of ten patients

Abstract

Objective To investigate the causes and countermeasures of reoperation following laparoscopic pancreatoduodenectomy. Methods The causes, approaches and outcome of reoperation were retrospectively analyzed in 10(4.0%, 10/250) patients undergoing reoperations following pancreaticoduodenectomy with various complications in Hunan Provincial People’s Hospital from April 2014 to April 2018. Results The causes of the 10 patients including intra-abdominal bleeding of seven cases (2 cases combined with pancreatic fistula, 1 case with pancreatic and biliary fistula), 1 patient with gastrointestinal anastomosis output perforation, 1 patient with intra-abdominal abscess, and 1 case with postoperative pancreatitis. The time of reoperation was one day to 82 day after the first operation. The main methods of reoperation including suture and hemostasis, rebuilding the digestive tract, gastrostomy and enterostomy combined with abdominal cavity drainage. The mortality of reoperation following laparoscopic pancreatoduodenectomy was 20.0%(2/10). Conclusions Intra-abdominal hemorrhage, pancreatic fistula and intra-abdominal abscess are the major causes of reoperation after laparoscopic pancreatoduodenectomy. Timely and decisive reoperation is an effective means to reduce postoperative morbidity and mortality after LPD. Key words: Pancreaticoduodenectomy; Laparoscope; Postoperative complications; Reoperation; Mortality