Pancreato-jejunal anastomosis still represents the main source of postoperative complications after pancreatoduodenectomy. In this study a technique of occlusion of the residual pancreatic stump instead of pancreato-jejunal anastomosis is proposed. Between March 1981 and July 1988 we performed 68 pancreatoduodenectomies using Neoprene injection in the Wirsung duct for pancreatic carcinoma of the head (39 cases), ampullary carcinoma (17 cases), islet cells carcinoma (6 cases) and chronic pancreatitis (6 cases). We observed a 33.8% overall morbidity, with a 4.4% operative mortality. The complications observed seemed not to be related to pancreatic stump occlusion technique, except for 2 pancreatic fistulas which spontaneously resolved. Abdominal ultrasound and computerized tomography scan performed during the follow-up did not show any significant morphological alteration of the residual stump. Pancreatic endocrine function was assessed in 10 patients by evaluating blood glucose, plasma insulin and plasma glucagon levels at fasting and after oral glucose and intravenous arginine infusion; these tests were performed before surgery and 15 days, 6 months, 1, 2 and 3 years after surgery. The results showed that 60% of the patients had impaired glucose tolerance before surgery and this percentage has not significantly changed up to three years later (75%). Nobody developed diabetes, and only one patient progressed from normal to impaired glucose tolerance. In conclusion intraductal injection of Neoprene after pancreatoduodenectomy seems to be a safe procedure instead of pancreatojejunal anastomosis and does not induce a post-surgical diabetes.
|Translated title of the contribution||Neoprene injection into the Wirsung duct after pancretoduodenectomy instead of pancreato-jejunal anastomosis|
|Number of pages||4|
|Publication status||Published - 1992|
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