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Chronic pancreatitis, Indications for Resection Procedures and Postoperative Complications


Authors: J. Kaťuchová;  J. Bober;  P. Závacký
Authors‘ workplace: I. chirurgická klinika LF UPJŠ a FNLP Košice, Slovenská republika, prednosta: prof. MUDr. J. Bober, CSc.
Published in: Rozhl. Chir., 2008, roč. 87, č. 4, s. 200-206.
Category: Monothematic special - Original

Overview

Introduction:
During the past three decades, important advances in understanding of the pathophysiology of chronic pancreatitis improved results of major pancreatic resections. Besides Whipple procedure, Beger and Frey procedures are now frequently performed.

Material and Methods:
Between January 1996 and December 2005, the findings for 65 patients suffer from chronic pancreatitis were analyzed in this retrospective trial at the I. Department of Surgery University Hospital FN LP in Košice. Short-term results were investigated, 30 days after surgery: pancreatic leak, billiary leak and leak from gastrointestinal anastomosis, hemorrhagic complications, delayed gastric emptying, intraabdominal absces.

Results:
The overall mortality rate was 4.6% and morbidity rate was 36.7%. Specific (for pancreatic resection) complications were indentified in 15 patients (23%): pancreatic fistula in 4 patients (6.1%), intra-abdominal absces in 5 patients (7.7%), delayed gastric emptying in 4 patients (6.1%), intra-abdominal bleeding in one patient (1.5%) and trombosis of portal vein in one patient (1.5%). Non-specific complications were in 9 patients, 13%.

Conclusion:
An analysis of postoperative complications shows that type of pancreatic anastomosis as well as using Octreotid have no influence to pancreatic fistula. The texture of pancreas is main risk factor to develope pancreatic fistula. Incidence of postoperative complications depends on blood lose and using transfusion units.

Key words:
chronic pancreatitis – pancreatic resection – complications


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