Cic edizioni internazionali
Il Giornale di Chirurgia

A novel reconstructive strategy for pancreaticoduodenectomy following Roux-en-Y distal gastrectomy

Original Article, 399 - 402
doi: 10.11138/gchir/2018.39.6.399
Tag this article
Abstract
Full text PDF
The rate of pancreaticoduodenectomy (PD) performed for both benign and malignant periampullary diseases has increased. In addition,
Roux-en-Y reconstruction after distal gastrectomy for cancer or ulcer is still widely used. Therefore, a surgeon may be confronted with a partially- gastrectomized patient who needs a PD. This is a very challenging circumstance for surgeons because of adhesions, bloodstream, anatomical changes and length of the remnant intestine.
In our experience, we performed two pancreaticoduodenectomies after distal gastrectomy in patients with periampullary tumors. We preserve gastrojejunal anastomosis and perform an end-to-side pancreaticojejunostomy (PJ) on the afferent limb of gastrojejunal anastomosis and a termino-lateral hepaticojejunal anastomosis on an independent
transmesocolic Roux-en-Y limb.
In literature, few cases of PD after distal gastrectomy are reported and most of them consider only PD after Billroth II reconstruction.
Many authors have demonstrated pancreaticogastrostomy (PG) is superior to PJ in terms of lower risk of pancreatic and biliary fistula, but it is not possible to anastomose pancreas stump with gastric wall in patients who have been undergone distal gastrectomy. For this reason, we retrospectively review our experience about PD following distal gastrectomy and suggest a novel standardized technique which allow surgeons to benefit from same advantages of a typical PG also in this group of patients.

Vol. XL (No. 1) 2019 January - February

  1. Raffaele Bastianelli: Magister sine cathedra
    Di Matteo G.
  2. Thrombotic complications in inflammatory bowel diseases
    Fornaro R., Caristo G., Stratta E., Caratto M., Caratto E., Giovinazzo D., Di Maira L., Casaccia M., Frascio M.
  3. Early diagnosis of anastomotic leakage after colorectal surgery by the Dutch leakage score, serum procalcitonin and serum C-reactive protein: study protocol of a prospective multicentre observational study by the Italian ColoRectal Anastomotic Leakage (iC
    Benedetti M., Ciano P., Pergolini I., Ciotti S., Guercioni G., Ruffo G., Borghi F., Patriti A., Del Rio P., Scatizzi M., Mancini S., Garulli G., Carrara A., Pirozzi F., Scabini S., Liverani A., Baiocchi G., Campagnacci R., Muratore A., Longo G., Caricato M., Macarone Palmieri R., Vettoretto N., Caccaroni M., Guadagni S., Bertocchi E., Cianflocca D., Lambertini M., Pace U., Baraghini M., Pandolfini L., Angeloni R., Lucchi A., Martorelli G., Tirone G., Motter M., Sciuto A., Martino A., Luzzi A.P., Di Cesare T., Molfino S., Maurizi A., Marsanic P., Tomassini F., Santoni S., Capolupo G.T., Amodio P., Arici E., Clementi M., Ruggeri B., Catarci M.
  4. Open inguinal hernia repair with self-gripping Parietex ProGrip mesh: a retrospective study of 204 cases
    Del Papa M., D'Amata G., Manzi F., Carnì P., Florio G., Crovaro M., Musmeci L., Buonocore C.
  5. Use of the KSVM-based system for the definition, validation and identification of the incisional hernia recurrence risk factors
    Licari L., Salamone G., Campanella S., Carfì F., Fontana T., Falco N., Tutino R., De Marco P., Comelli A., Cerniglia D., Petrucci G., Vitabile S., Gulotta G.
  6. Colocutaneous fistula through ulcerative colitis and cancer to the pyoderma gangrenosum: a never-ending story for a single patient. Case report
    Eberspacher C., Mascagni D., Fralleone L., Maturo A., Di Matteo F.M., De Cristofaro F., Merletti D., Santoro A., Mascagni P., Pontone S., Pironi D.
  7. Amyand’s hernia: role of CT for a correct diagnosis
    Drago A., Carbone M., Lorusso V., Moschetta M., Scardapane A., Lucarelli N., Angelelli G., Stabile Ianora A.A.
  8. Modular megaprosthesis as definite treatment of femur osteomyelitis
    Koutserimpas C., Raptis K., Mari A., Kotsirakis A.
  9. Testicular torsion in a newborn: a case report
    Blevrakis E., Xenaki S., Chrysos E.
  10. Surveillance of pregnant women with potential exposure to Zika virus following travel
    Spiliopoulos D., Panchal M., Economides D.L.
  11. Mesenteric cyst and recurrent abdominal pain in a patient with Gorlin-Goltz syndrome: a case report
    Monaco L., Guida F., D'Onofrio G., Di Martino N.
  12. Squamous carcinoma in pilonidalis sinus: case report and review of literature
    Delvecchio A., Laforgia R., Sederino M.G., Minafra M., Carbotta G., Balducci G., Fabiano G., Fedele S., Palasciano N.
  13. congresses, academies, societies
    Di Matteo G.
Last Viewed articles: la lista degli ultimi x visitati.
  1. A novel reconstructive strategy for pancreaticoduodenectomy following Roux-en-Y distal gastrectomy
    Fedele S., Bizzoca C., Delvecchio A., Lafrancechina S., Papagni V., Picciariello A., Pisicchio S., Basile R., Vincenti L.
    doi: 10.11138/gchir/2018.39.6.399
credits