Digestive surgery · 2008
Usefulness of pancreatic duct stenting prior to surgery as a guide to decide the feasibility of limited pancreatic resection.
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Okamoto Tomoyoshi, Gocho Takeshi, Futagawa Yasuro, Fujioka Shuichi, Yanaga Katsuhiko, Ikeda Keiichi, Kakutani Hiroshi, Tajiri Hisao
Аннотация
BACKGROUND/AIMS: The purpose of this study was to introduce our procedure of limited pancreatic resection with preoperative pancreatic duct stenting to prevent complications.
PATIENTS AND METHODS: Subjects comprised 6 patients with neoplasm who underwent preoperative pancreatic stenting. Pancreatic stents were placed within 7 days before elective surgery. After intraoperative ultrasonography, the relationship between the main pancreatic duct (MPD) and the lesion was confirmed by measuring the distance. Partial resection was surrendered if a sufficient margin of excised tumor was not obtained or injury to the MPD was likely to occur. Branches of pancreatic duct recognized were ligated as much as possible.
RESULTS: Mild pancreatitis was present after stenting in 2 patients. Three patients actually underwent partial resection. In patients with partial resection, enhanced visualization of the MPD was useful for deciding the operative procedure and prevented iatrogenic injury to the MPD during dissection.
CONCLUSIONS: Pancreatic duct stenting prior to pancreatic surgery seems useful as a guide for determining the feasibility of limited pancreatic resection and to prevent missing injury to the MPD.
PATIENTS AND METHODS: Subjects comprised 6 patients with neoplasm who underwent preoperative pancreatic stenting. Pancreatic stents were placed within 7 days before elective surgery. After intraoperative ultrasonography, the relationship between the main pancreatic duct (MPD) and the lesion was confirmed by measuring the distance. Partial resection was surrendered if a sufficient margin of excised tumor was not obtained or injury to the MPD was likely to occur. Branches of pancreatic duct recognized were ligated as much as possible.
RESULTS: Mild pancreatitis was present after stenting in 2 patients. Three patients actually underwent partial resection. In patients with partial resection, enhanced visualization of the MPD was useful for deciding the operative procedure and prevented iatrogenic injury to the MPD during dissection.
CONCLUSIONS: Pancreatic duct stenting prior to pancreatic surgery seems useful as a guide for determining the feasibility of limited pancreatic resection and to prevent missing injury to the MPD.