Surgical approaches for pancreatic ascites: report of three cases.

Abstract:

:Pancreatic ascites can occur in association with the rupture of a pseudocyst or the disruption of a pancreatic duct during the natural course of chronic pancreatitis. We report herein the successful treatment of three patients with pancreatic ascites by performing a surgical procedure after 4-6 weeks of total parenteral nutrition (TPN) proved ineffective. The principles of our surgical procedure for pancreatic ascites are as follows: (1) minimum pancreatic tissue is resected; (2) surgical intervention to repair leaking sites is not necessary; (3) pancreatic duct drainage is facilitated by an intestinal Roux-en-Y loop; (4) An external drainage tube is inserted through the Roux-en-Y loop into the main pancreatic duct. All three patients who underwent our surgical procedure had a good outcome. Although the mean follow-up time is still only 18.3 months, their condition has improved, with no evidence of recurrent ascites. Thus, our surgical procedure should be considered as an appropriate treatment for pancreatic ascites because it can be applied for all types of leakage, including leakage from the posterior wall of pancreas; it preserves pancreatic function, especially endocrine function; and it enables preservation of the spleen.

journal_name

Surg Today

journal_title

Surgery today

authors

Ohge H,Yokoyama T,Kodama T,Takesue Y,Murakami Y,Hiyama E,Matsuura Y

doi

10.1007/BF02483041

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

458-61

issue

5

eissn

0941-1291

issn

1436-2813

pii

10.1007/BF02483041

journal_volume

29

pub_type

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