Role of completion pancreatectomy as a damage control option for post-pancreatic surgical complications.

Abstract:

INTRODUCTION:Management of pancreatic leak and haemorrhage is complex with high mortality rates. In this study, the results of completion pancreatectomy which was performed as a last resort option were analysed. PATIENTS AND METHODS:25 patients who had completion pancreatectomy from among 677 patients who had pancreatoduodenectomy or distal pancreatectomy over a period of 18 years were analysed in terms of the indications for completion pancreatectomy, outcome and survival data. RESULTS:Indications for completion pancreatectomy include pancreatic leak in 12 patients (48%), both bleeding and pancreatic leak in 8 (32%), and haemorrhage alone in 5 (20%) patients. 18 (72%) patients also had splenectomy. Median ITU stay was 4 and 8 days for those who survived and died post-completion pancreatectomy, respectively. 36% patients had septicaemia and 32% patients had multiple organ failure. 12 patients survived the operation with a median survival of 52 months. CONCLUSION:25 (3.6%) patients required surgical intervention for pancreatic complications. The incidence of splenectomy was 84.6% in those who died after completion pancreatectomy compared to 58.3% of those who survived (Fisher's exact test two-sided 0.20). Despite significant morbidity and mortality, completion pancreatectomy has a role in the management of post-pancreatic surgical complications.

journal_name

Dig Surg

journal_title

Digestive surgery

authors

Tamijmarane A,Ahmed I,Bhati CS,Mirza DF,Mayer AD,Buckels JA,Bramhall SR

doi

10.1159/000095395

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

229-34

issue

4

eissn

0253-4886

issn

1421-9883

pii

95395

journal_volume

23

pub_type

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