The incidental diagnosis of intraductal papillary mucinous neoplasms (IPMNs) in patients with liver cirrhosis doubles that of controls

Abstract

s / Pancreatology 15 (2015) S1eS141 S121 Aims:Wewent in order to clarify the effect of three continuous suction drainages to avoid severe pancreatic fistula in patients with soft pancreas after pancreaticoduodenectomy. Patients & methods: This is a retrospective review of 40 patients who underwent PD for periampullary cancer. The remnant pancreas showed a soft texture in all cases. Reconstruction was undertaken with Child procedure. And duct-tomucosa anastomosis (sub-total diversion) was used in pancreaticojejunostomy (PJ). PF was diagnosed according to the International Study Group for Pancreatic Fistula (ISGPF). All patients (n1⁄440) were divided into 2 groups. Group1 (n1⁄414) patients having drainage tubes behind the foramen of Winslow and dorsal space of PJ, Group2 (n1⁄426): patients having an additional tube in caudal space of left lobe of liver. We compared postoperative pancreatic fistula (POPF) severity, additional treatment and mortality between these groups. Results: There were no differences in the background of the two groups. 13 patients developed into PF. Incidence of grade B and C POPF in group1 and 2 was 50% and 11% respectively. Seven of 14 patients in group1 complicated pancreatic fistula and 4 patients required ultrasonic-guided percutaneous drainage. Notably, the all abscess site spread in caudal space of left lobe of liver. Although 8 patients in group2 developed into PF, they required only anti-biotic drug. Conclusion: Three adequate continuous drainages can prevent POPF after PD from developing into fatal complication.