Pancreatic Atrophy Relative to External Versus Internal Drainage of the Pancreatic Duct After Pylorus-Preserving Pancreaticoduodenectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-07-08

AUTHORS

Daegwang Yoo, Shin Hwang, Ki-Hun Kim, Chul-Soo Ahn, Deog-Bok Moon, Tae-Yong Ha, Dong-Hwan Jung, Gil-Chun Park, Bo-Hyun Jung, Sung-Hwa Kang, Sung-Gyu Lee

ABSTRACT

BackgroundAtrophy of the pancreatic parenchyma, which occurs frequently after pylorus-preserving pancreaticoduodenectomy (PPPD), is often associated with pancreatic exocrine insufficiency. Many surgeons prefer to insert a drainage tube into the remnant pancreatic duct primarily to prevent pancreatic leakage at the pancreaticojejunostomy (PJ) after PPPD. Drainage methods vary widely but can be roughly classified as internal or external drainage. This study intended to evaluate their effects on pancreatic parenchymal atrophy following PPPD.MethodsFifty-seven patients who underwent PPPD were retrospectively divided into two groups, 28 who underwent external and 29 who underwent internal pancreatic drainage. External drainage tubes were removed 4 weeks after PPPD. The volume of the pancreatic parenchyma was serially measured on abdominal computed tomography (CT) scans before PPPD, as well as 7 days and 3, 6, and 12 months after surgery. Degree of pancreatic parenchymal atrophy was determined by calculating pancreatic volume relative to that on day 7.ResultsUnivariate analysis showed that patient sex, age, body mass index, concurrent pancreatitis, pathology, and types of PJ did not significantly affect changes in pancreatic volume following PPPD. The degree of pancreatic volume atrophy did not differ significantly in the external and internal drainage groups. No patient in the external drainage group experienced drainage-related surgical complications. The incidence of PJ leak was comparable in the two groups. Postoperative pancreatic atrophy did not induce new-onset diabetes mellitus at 1 year.ConclusionsBoth external and internal pancreatic drainage methods showed similar atrophy rate of the pancreatic parenchyma following PPPD. More... »

PAGES

1604-1609

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-014-2583-4

DOI

http://dx.doi.org/10.1007/s11605-014-2583-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1025267357

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25002021


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28 schema:description BackgroundAtrophy of the pancreatic parenchyma, which occurs frequently after pylorus-preserving pancreaticoduodenectomy (PPPD), is often associated with pancreatic exocrine insufficiency. Many surgeons prefer to insert a drainage tube into the remnant pancreatic duct primarily to prevent pancreatic leakage at the pancreaticojejunostomy (PJ) after PPPD. Drainage methods vary widely but can be roughly classified as internal or external drainage. This study intended to evaluate their effects on pancreatic parenchymal atrophy following PPPD.MethodsFifty-seven patients who underwent PPPD were retrospectively divided into two groups, 28 who underwent external and 29 who underwent internal pancreatic drainage. External drainage tubes were removed 4 weeks after PPPD. The volume of the pancreatic parenchyma was serially measured on abdominal computed tomography (CT) scans before PPPD, as well as 7 days and 3, 6, and 12 months after surgery. Degree of pancreatic parenchymal atrophy was determined by calculating pancreatic volume relative to that on day 7.ResultsUnivariate analysis showed that patient sex, age, body mass index, concurrent pancreatitis, pathology, and types of PJ did not significantly affect changes in pancreatic volume following PPPD. The degree of pancreatic volume atrophy did not differ significantly in the external and internal drainage groups. No patient in the external drainage group experienced drainage-related surgical complications. The incidence of PJ leak was comparable in the two groups. Postoperative pancreatic atrophy did not induce new-onset diabetes mellitus at 1 year.ConclusionsBoth external and internal pancreatic drainage methods showed similar atrophy rate of the pancreatic parenchyma following PPPD.
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35 schema:keywords Atrophy Relative
36 BackgroundAtrophy
37 ConclusionsBoth
38 External Versus Internal Drainage
39 MethodsFifty-seven patients
40 PJ leak
41 PPPD
42 Pancreatic Atrophy Relative
43 Postoperative pancreatic atrophy
44 Versus Internal Drainage
45 abdominal computed tomography scan
46 age
47 analysis
48 atrophy
49 atrophy rates
50 body mass index
51 changes
52 complications
53 computed tomography scan
54 concurrent pancreatitis
55 days
56 degree
57 diabetes mellitus
58 drainage
59 drainage group
60 drainage method
61 drainage tube
62 drainage-related surgical complications
63 duct
64 effect
65 exocrine insufficiency
66 external drainage
67 external drainage group
68 external drainage tube
69 group
70 incidence
71 index
72 insufficiency
73 internal drainage
74 internal drainage group
75 internal pancreatic drainage
76 internal pancreatic drainage methods
77 leak
78 leakage
79 mass index
80 mellitus
81 method
82 months
83 new-onset diabetes mellitus
84 pancreatic atrophy
85 pancreatic drainage
86 pancreatic drainage methods
87 pancreatic duct
88 pancreatic exocrine insufficiency
89 pancreatic leakage
90 pancreatic parenchyma
91 pancreatic parenchymal atrophy
92 pancreatic volume
93 pancreatic volume atrophy
94 pancreaticoduodenectomy
95 pancreaticojejunostomy
96 pancreatitis
97 parenchyma
98 parenchymal atrophy
99 pathology
100 patient sex
101 patients
102 pylori
103 rate
104 relatives
105 remnant pancreatic duct
106 scans
107 sex
108 similar atrophy rate
109 study
110 surgeons
111 surgery
112 surgical complications
113 tomography scan
114 tube
115 type of pancreaticojejunostomy
116 types
117 volume
118 volume atrophy
119 weeks
120 years
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