<abstract xmlns="http://www.w3.org/1999/xhtml">Introduction: One of the most feared complications after cephalic duodeno-pancreatectomy remains pancreatic fistula. In recent years, various methods of pancreatico-digestive reconstruction were performed in order to reduce the rate of pancreatic fistula. One of these methods is pancreatico-gastric reconstruction by using two purse string threads. Case report: We present in this article a patient with jaundice with mixed etiology: tumoral and lithiasic. Subjectively, the patient accused sclerose-skin-jaundice, right upper quadrant and epigastric pain, nausea and vomiting. Computed tomography revealed dilatation of intraand extrahepatic bile ducts, a dilated Wirsung duct and a tumor at the biliopancreatic confluence, leading to a suspicion of vaterian ampulom. Upper endoscopy revealed a tumor protruding in the descending duodenal segment. Intraoperatively a tumor suggestive of vaterian ampulom and duct stones was shown. Surgical treatment consisted of coledocolitotomy, cephalic duodeno-pancreatectomy with pancreatic-gastric anastomosis, performed by using two purse string threads. The postoperative evolution was favorable. Conclusion: Pancreatico-gastric anastomosis using two purse string threads is a simple, safe and quick procedure, avoiding the application of sutures through the pancreatic parenchyma and thus reducing the rate of pancreatic fistula.</abstract>

Introduction: One of the most feared complications after cephalic duodeno-pancreatectomy remains pancreatic fistula. In recent years, various methods of pancreatico-digestive reconstruction were performed in order to reduce the rate of pancreatic fistula. One of these methods is pancreatico-gastric reconstruction by using two purse string threads. Case report: We present in this article a patient with jaundice with mixed etiology: tumoral and lithiasic. Subjectively, the patient accused sclerose-skin-jaundice, right upper quadrant and epigastric pain, nausea and vomiting. Computed tomography revealed dilatation of intraand extrahepatic bile ducts, a dilated Wirsung duct and a tumor at the biliopancreatic confluence, leading to a suspicion of vaterian ampulom. Upper endoscopy revealed a tumor protruding in the descending duodenal segment. Intraoperatively a tumor suggestive of vaterian ampulom and duct stones was shown. Surgical treatment consisted of coledocolitotomy, cephalic duodeno-pancreatectomy with pancreatic-gastric anastomosis, performed by using two purse string threads. The postoperative evolution was favorable. Conclusion: Pancreatico-gastric anastomosis using two purse string threads is a simple, safe and quick procedure, avoiding the application of sutures through the pancreatic parenchyma and thus reducing the rate of pancreatic fistula.

Cephalic Duodeno-Pancreatectomy with Pancreatic-Gastric Anastomosis with Double Purse String, in Patient with Lithiasis and Tumoral Jaundice - Case Report

University of Medicine and Pharmacy Tirgu-Mures

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction: One of the most feared complications after cephalic duodeno-pancreatectomy remains pancreatic fistula. In recent years, various methods of...

Cephalic Duodeno-Pancreatectomy with Pancreatic-Gastric Anastomosis with Double Purse String, in Patient with Lithiasis and Tumoral Jaundice - Case Report

Published Online: Dec 04, 2014

Page range: 227 - 230

Received: Oct 07, 2014

Accepted: Oct 29, 2014

DOI: https://doi.org/10.2478/amma-2014-0047

Keywords
cephalic duodeno-pancreatectomy, pancreatic fistula, double purse string, pancreatico-gastric anastomosis

© by C Molnar

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Cephalic Duodeno-Pancreatectomy with Pancreatic-Gastric Anastomosis with Double Purse String, in Patient with Lithiasis and Tumoral Jaundice - Case Report

Published Online: Dec 04, 2014

Page range: 227 - 230

Received: Oct 07, 2014

Accepted: Oct 29, 2014

DOI: https://doi.org/10.2478/amma-2014-0047

Keywordscephalic duodeno-pancreatectomy, pancreatic fistula, double purse string, pancreatico-gastric anastomosis

© by C Molnar

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
cephalic duodeno-pancreatectomy, pancreatic fistula, double purse string, pancreatico-gastric anastomosis