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Pancreaticoduodenectomy (Whipple’s procedure) remains the only definitive treatment option for tumors of the periampullary region. The most common and life-threatening complications following the procedure are pancreatic anastomotic leakage and subsequent fistula formation. When these complications occur, treatment strategy depends on the severity...
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Purpose
Choledochojejunostomy can be performed with either interrupted sutures (IS) or continuous sutures (CS). No reports have compared the short- or long-term patient outcomes resulting from these two methods.
Methods
A total of 228 consecutive patients who underwent pancreaticoduodenectomy or total pancreatectomy were prospectively enrolled in...
Purpose
In total gastrectomy, Roux-en-Y reconstruction with esophagojejunal anastomosis has been widely used in gastrointestinal reconstruction. In the case of anastomotic leakage of RY reconstruction, esophagojejunal anastomosis should be paid attention, and esophageal fragility is considered the reason for the leakage. Here, we introduce an atrau...
Citations
... Post-operative pancreatic fistula is a formidable complication of pancreatic surgery and various methods have been used to prevent its occurrence and control the damages which ensue [164]. Use of HRL proves most successful in this attempt when employed as a pedicled flap to cover the cut surface of the pancreas following distal pancreatectomy or enucleation and as a buttress to pancreato-jejunal o r p a n c r e a t o -g a s t r i c a n a s t o m o s i s f o l l o w i n g pancreatoduodenectomy (Fig. 9), both prophylactically and therapeutically (Table 6) [115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130]. Leak rates following such a coverage vary from as low as 0% to those equalling historic controls [115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130]. ...
... Use of HRL proves most successful in this attempt when employed as a pedicled flap to cover the cut surface of the pancreas following distal pancreatectomy or enucleation and as a buttress to pancreato-jejunal o r p a n c r e a t o -g a s t r i c a n a s t o m o s i s f o l l o w i n g pancreatoduodenectomy (Fig. 9), both prophylactically and therapeutically (Table 6) [115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130]. Leak rates following such a coverage vary from as low as 0% to those equalling historic controls [115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130]. Although the overall rate of POPF remains unaltered, clinically significant POPF and its duration reduces significantly [120,121,125,127], resulting in reduced readmissions and interventions [119]. ...
... Although the overall rate of POPF remains unaltered, clinically significant POPF and its duration reduces significantly [120,121,125,127], resulting in reduced readmissions and interventions [119]. A potentially fatal complication after pancreatic resections is post-pancreatectomy haemorrhage [123][124][125]. It is often consequent to and in up to 40% of cases associated with POPF [123][124][125]. ...
Background and purposeDespite their ubiquitous presence, easy availability and diverse possibilities, falciform ligament and hepatic round ligament have been used less frequently than their potential dictates. This article aims to comprehensively review the applications of hepatic round ligament/falciform ligament flap and graft in abdominal surgery and assess their utility and efficacy.Methods
Medical literature/indexing databases were searched, using internet search engines, for pertinent articles and analysed.ResultsThe studied flap and graft have found utility predominantly in the management of diaphragmatic hernias, gastro-oesophageal reflux disease, peptic perforations, biliary reconstruction, venous reconstruction, post-operative pancreatic fistula, post-pancreatectomy haemorrhage, hepatic cyst cavity obliteration, liver bleed, sternal dehiscence, splenectomy, reinforcement of aortic stump, feeding access, diagnostic/therapeutic access into portal system, composite tissue allo-transplant and ventriculo-peritoneal shunting where they have exhibited the desired efficacy.Conclusions
Hepatic round ligament/falciform ligament flap and graft are versatile and have multifarious applications in abdominal surgery with some novel and unique uses in hepatopancreaticobiliary surgery including liver transplantation. Their evident efficacy needs wider adoption to realise their true potential.
