S Bacaliuc | PubMed Health

PubMed1995

[Pancreatoduodenectomy with pancreaticogastric anastomosis].

There is not general agreement concerning the ideal way of preventing pancreatic leakage after duodenopancreatectomy. The aim of the present study is to present the experience of a three years period of performing a pancreatogastroanastomosis (PGA) after duodenopancreatectomy (DPC) in 12 consecutive patients. In 7 cases PGA was performed after closure of the gastric stump using a transverse incision of the posterior wall of the stomach. A total layer of nylon 9 points was doubled by an interrupted serocapsular suture. In one case only the seromuscular layers of the stomach were cut, adjusted to the size of the pancreatic section with a central hole for the duct of Wirsung. Four nylon 10 points were used to anastomose the latter to the gastric mucosa. PGA was performed in one layer interrupted suture between the pancreatic capsule and the seromuscular of the stomach. In 4 cases, after closure of the gastric stump an anterior gastrotomy was associated to the posterior incision of the gastric wall in order to perform PGA using an intragastric route. The postoperative follow-up showed a good evolution with only one anastomotic leakage that necessitated reintervention in the 10th day. PGA might be elective after DPC when appropriate dissection and mobilisation of the pancreas is possible.

Adenocarcinoma↗

PubMedDate not supplied

[Palliative total gastrectomy].

Gastric cancer, because of lymphonodulary and local extension, often allows only palliative surgery. This study tries to present the total gastrectomy as an alternative meant to improve the life of the patients who cannot hope to radical cure. Thirty-one patients were submitted to this operation during the last five years. The main indication for surgery was cancer extended to the gastric corpus, mainly on the posterior aspects and almost reaching the cardia. Because of lymphonodulary invasion over N2, hepatic and pancreatic and colonic invasion over N2, hepatic and pancreatic and colonic invasion and because of the metastases, the resections were palliative. The operations consisted of total gastrectomy and omentectomy, without trying to reach lymphatic stations over NI. All cases presented evidence of restant cancerous tissue involving the pancreas, the liver or the other lymphatic stations, but the main purpose was the ablation of the gastric tumor. Postoperatively we recorded 3 deaths, 9 anastomotic fistulae and an average survival of 9 months (6-13 months).

Aged↗