NOTA CLÍNICA. Encefalopatía de Wernicke tras duodenopancreatectomía cefálica. Wernicke’s encephalopathy after cephalic pancreaticoduodenectomy. duodenopancreatectomía cefálica o cirugía de Whipple. El cáncer de páncreas es el más frecuente de estos tumores. Es un tumor de comportamiento muy. La cirugía con la técnica de Whipple, o duodenopancreatectomía, es la cirugía que se realiza con mayor frecuencia para el cáncer de páncreas. En un.

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Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: This implies an overall variant prevalence of 7.

Patients with a hepatic artery arising from superior mesenteric artery; and Group B: Scolding N, Marsden CD. Comparing the presence of external or internal drainage, a study by Tani et al[ 23 ] in concluded that there was no significant difference between the implementation of internal or external drainage, and concurred with a meta-analysis in which it was stated that internal drainage does not affect the development of fistulas and is not useful in a soft pancreas[ 24 ].

In agreement with the published literature, we have observed a slight increase in operating time in the group A.

To evaluate postoperative morbidity, we use Clavien-Dindo classification 7 Table I. Please review our privacy policy. In our series, the presence of a variant hepatic artery appears to have no impact on the radicality of tumor resection. This procedure seems especially useful to prevent stenosis of the cefalicz duct during anastomosis. An aspirating nasogastric tube is always recommended.

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Colangitis por obstrucción de asa aferente tras duodenopancreatectomía cefálica | Cirugía Española

A systematic review of the literature was performed, including major meta-analysis articles, clinical randomized trials, systematic reviews, and retrospective studies. PJ, and variations thereof, has been the technique most frequently used, although PG is a good alternative.

Wernicke’s encephalopathy is an acute neurological disorder resulting from thiamine deficiency. Oxford Tetxbook of Medicine.

Reconstruction after pancreatoduodenectomy: Pancreatojejunostomy vs pancreatogastrostomy

During surgery it is possible to injury a hepatic artery arising from SMA or otherwise may compromise the R0 resection in an attempt to preserve it.

Shen Y, Jin W. At any rate, there are no studies showing the superiority of any of these cevalica. J Gastrointest Surg ;8: Some reports describe techniques with the interposition of a vein or prosthetic graft 22, Use of occlusive substances: We duodenopancfeatectomia not use mesenteric trunk arteriography. The drain is left without pinching for the first postoperative days usually dthen can be clamped once healing is achieved, so that the pancreatic secretion passes.

Idea to prevent serious complications. In conclusion, up to now none of the techniques can be considered superior or be recommended as standard for reconstruction after PD. The complexity of having it does not seem to influence in tumor resection margins, complications and survival.

Chin Med J Engl ; Therefore, if the variant presents an intraparenchymal course or is infiltrated by the tumor, it may be necessary to perform an arterial resection and later revascularization Successful resection of distal hepatic duodenopancreatectomix aneurysm with graft reconstruction of the hepatic arteries. Its use in the West is limited.


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Arterial variant involves a technical difficulty that may determine a more conservative resection of the pancreas, especially for retropancreatic plane and lead an inadequate removal of the tumor 9.

Described by Peng et al[ 12 ] inthe technique includes three modifications: World J Gastrointest Oncol.

The impact of internal or external transanastomotic pancreatic duct stents following pancreaticojejunostomy. It can be performed easily, because the posterior wall of the stomach lies immediately anterior to the mobilized pancreatic remnant and is usually wider than the transected pancreas.

Am J Roentgenol ; Pancreatoduodenectomy, Pancreatojejunostomy, Pancreatogastrostomy, Pancreatic fistula, Pancreatic cancer, Surgical technique. Although we have not identified any inadvertent section of the variants in our study, there are some case-series that reported compatible findings with hepatic necrosis or ischemia of the hepato-jejunal anastomosis Remaining cases were identified during surgical dissection. The reported technique for PD was variable. Cases J, 2pp. Blumgart anastomosis for pancreaticojejunostomy minimizes severe complications after pancreatic head resection.

Postoperative delayed emptying in pylorus-preserving pancreatoduodenectomy using pancreaticogastrostomy: