This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (14)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Surgery  • Surgical Interventions  • Endocrine Surgery  • Alert me on articles by topic  Social Bookmarking   What's this?

Early and Late Outcome

Sylvie Gueroult, MD; Yann Parc, MD, PhD; Françoise Duron, MD; Françoise Paye, MD, PhD; Rolland Parc, MD

Arch Surg. 2004;139:16-19.

Hypothesis  Completion pancreatectomy in patients with pancreatic leakage associated with postoperative peritonitis after pancreaticoduodenectomy is a viable salvage procedure.

Design  Retrospective analysis from a cohort of consecutive patients admitted between January 1, 1989, and December 31, 1999, for postoperative peritonitis originating from pancreaticojejunostomy leakage.

Setting  Tertiary referral center with surgical intensive care unit specializing in the treatment of intra-abdominal sepsis.

Patients  Eight consecutive patients with postoperative peritonitis originating from pancreaticojejunostomy after pancreaticoduodenectomy, with a mean Acute Physiology and Chronic Health Evaluation II score of 18.6. We excluded patients with pancreatic fistulas or abscesses amenable to percutaneous drainage or other conservative treatment.

Intervention  Completion pancreatectomy.

Main Outcome Measures  Mortality, morbidity, and long-term outcome, which was assessed by interview.

Results  Three patients died in the postoperative period: 2 required early reoperation during the postoperative period and died of hemorrhage and sepsis, and 1 died of multiorgan failure without reoperation. Recurrence of carcinoma was responsible for late death of 2 other patients.

Conclusions  Posotperative peritonitis after pancreaticoduodenectomy still has high mortality; however, completion pancreatectomy may represent the only means to achieve source control of infection in cases of postoperative peritonitis.

From the Departments of Digestive Surgery (Drs Gueroult, Y. Parc, Paye, and R. Parc) and Endocrinology (Dr Duron), Hôpital Saint-Antoine, Assistance Publique/Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

This Month in Archives of Surgery
Arch Surg. 2004;139(1):13.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Pancreatogastrostomy as a Salvage Procedure to Treat Severe Postoperative Pancreatic Fistula After Pancreatoduodenectomy
Bachellier et al.
Arch Surg 2008;143:966-970.
ABSTRACT | FULL TEXT