Konstadoulakis MM, Filippakis GM, Lagoudianakis E, Antonakis PT, Dervenis C, Bramis J. J Surg Oncol. 2005 Mar 15;89(4):268-72.PMID: 15726611
Θεματολογία: Γενική Χειρουργική – Παγκρεας – Κλινική
Μεθοδολογία: Έρευνα
Αριθμός Ατόμων: 4
Αναφορές (Citations): Google Scholar: 8
Συντελεστής Απήχησης(Impact Factor): 2.384

Abstract

BACKGROUND AND OBJECTIVES: Leakage from the pancreaticojujenostomy is the most serious complication of Whipple. Pancreatic fistula rate is higher in cases of fragile pancreas often seen in duodenal carcinomas and carcinomas of the ampulla of Vater. Octreotide administration has been used for the prevention of fistula formation through the subcutaneous route. Due to its physiologic effects to the pancreatic parenchyma the intra-arterial administration of octreotide could provide tissue hardening that allows for a technically easier anastomosis while maintaining its protective role for fistula formation. METHODS: Octreotide was injected directly into the distal part of the gastroduodenal artery (GDA) in four patients undergoing Whipple for histologically proven periampullary cancer. RESULTS: Tissue hardening after octreotide administration was evident not only in surgeons' hands but in the intra-operative ultrasound as well. The three patients were discharged on day 9, 11, and 13; they had an uneventful postoperative course, while one patient had a minor bile leak from the choledojejunal anastomosis and was discharged on day 22. CONCLUSIONS: The intra-arterial administration of octreotide during Whipple is a safe procedure and provides tissue hardening thus making the performance of the anastomosis technically easier. The actual benefit in terms of morbidity, mortality, and fistula rate are to be further evaluated.

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2. Risk factors for pancreatic anastomotic leakage: the significance of preoperative dynamic magnetic resonance imaging of the pancreas as a predictor of leakage. Y Tajima, T Kuroki, R Tsutsumi, K Fukuda, A Kitasato, T Adachi, T Mishima, Takashi Kanematsu. Journal of the American College of Surgeons Volume 202, Issue 5, Pages 723-731 (May 2006)
3. Increased plasma levels of IL-6 and IL-8 are associated with surgical site infection after pancreaticoduodenectomy. F Kimura, H Shimizu, H Yoshidome, M Ohtsuka,…Pancreas, March 2006 - Volume 32 - Issue 2 - pp 178-185
4. Octreotide hardens the pancreas. T Foitzik, M Gock, C Schramm, F Prall, E … Langenbeck's Archives of Surgery Volume 391, Number 2 / April, 2006
5. Therapeutic strategies for the management of delayed gastric emptying after pancreatic resection. D Lytras, KI Paraskevas, C Avgerinos, C Manes, … Archives of Surgery, Volume 392, Number 1 / January, 2007.
6. Assessment of Pancreatic Hardness--Surgeon versus Durometer. O Belyaev, H Herden, JJ Meier, CA Muller. Journal of Surgical Research Volume 158, Issue 1, Pages 53-60(January2010).
7. Anatomy-Specific Pancreatic Stump Management to Reduce the Risk of Pancreatic Fistula After Pancreatic Head Resection. Y Tajima, T Kuroki, N Tsuneoka, T Adachi. World Journal of Surgery Volume 33, Number 10 / October, 2009.
8. Octreotid härtet das Pankreas. T Foitzik, M Gock, C Schramm, F Prall, E Klar.  Deutsche Gesellschaft für Chirurgie-Chirurgisches Forum 2006 Volume 35.