Decision-making in high-risk leakage duodenopancreatectomy:pancreatic anastomosis or total pancreatectomy?

作     者：Lazare Sommier Fabrizio Panaro 

作者机构：Division of HBP Surgery and TransplantationDepartment of SurgeryMontpellier University HospitalSchool of MedicineMontpellierFrance 

出 版 物：《Hepatobiliary Surgery and Nutrition》 (肝胆外科与营养（英文）)

年 卷 期：2023年第12卷第4期

页      面：567-569页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：High risk fistula pancreatic anastomosis pancreaticoduodenectomy(PD) total pancreatectomy(TP) 

摘      要：The Italian team from Verona,questions the place of total pancreatectomy(TP)as an alternative to pancreaticoduodenectomy(PD)in patients at high risk of pancreatic fistula in a monocentric retrospective study running from July 2017 to December 2019(1).A total of 702 patients were included,566 PD of which 101 were at high risk of pancreatic fistula(HR-PD),136 TP of which 86 were PD converted to TP(C-TP)for positive margin of pancreatic section for malignancy(49%),extensive vascular resection(14%)or technical reasons(27%)such as residual non-reconstructible pancreas/friable pancreas/microscopic Wirsung’s duct,10% for other reasons(bleeding......)Patients in the HR-PD group received externalized stent of the Wirsung duct.