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- Title
Protective peritoneal patch for arteries during pancreatoduodenectomy: good value for money.
- Authors
Palen, Anaïs; Garnier, Jonathan; Delpero, Jean-Robert; Turrini, Olivier; Ewald, Jacques
- Abstract
Purpose: This study proposes and details a simple and inexpensive protective technique of wrapping the hepatic and gastroduodenal artery stumps with a peritoneal patch during pancreatoduodenectomy (PD) in order to decrease post-pancreatectomy hemorrhage (PPH). Methods: Among the 85 patients who underwent PD between July 2020 and March 2021, 16 patients with high-risk pancreatic anastomosis received a peritoneal patch. The Updated Alternative Fistula Risk Score (ua-FRS) was calculated. Post-operative pancreatic fistula (POPF) and PPH were diagnosed and graded according to the International Study Group of Pancreatic Surgery. The mortality rate was calculated up to 90 days after PD. Results: The mean ua-FRS of the 16 patients was 43% (range: 21–63%). Among them, 6 (38%) experienced clinically relevant-POPF, and a PPH was observed in two patients (13%). In these two patients who required re-intervention, the peritoneal patch was remarkably intact, and neither the gastroduodenal stump nor hepatic artery was involved. None of the patients experienced 90-day mortality. Conclusion: Although the outcomes are encouraging, the evaluation of a larger series to assess the effectiveness of the peritoneal protective patch for arteries in a high-risk pancreatic anastomosis is ongoing.
- Subjects
PANCREATICODUODENECTOMY; DISEASE risk factors; HEPATIC artery; PANCREATIC surgery; ARTERIES
- Publication
Langenbeck's Archives of Surgery, 2022, Vol 407, Issue 1, p377
- ISSN
1435-2443
- Publication type
Article
- DOI
10.1007/s00423-021-02345-z