Minimally invasive pancreatic anastomosis after pancreaticoduodenectomy: multi-institutional step by step video description of the technique.
Minimally invasive surgery
Pancreatic anastomosis
Pancreaticoduodenectomy
Journal
Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
02
06
2022
accepted:
27
08
2022
pubmed:
14
11
2022
medline:
14
1
2023
entrez:
13
11
2022
Statut:
ppublish
Résumé
Minimally invasive pancreaticoduodenectomy (PD) is attracting increased interest in the pancreatic surgical community with more and more teams reporting their experience worldwide. The pancreatic anastomosis (PA) is one of the key steps and challenging manoeuvre of this procedure. Since the introduction of the minimally invasive approach for PD, several PA types have been proposed, ranging from high to low complexity, but none of them have been proven unequivocally superior to the others. Therefore, definitive consensus has not been reached yet. In the present multimedia manuscript, we report the most commonly adopted minimally invasive PA and we propose a "complexity classification" to guide the choice accordingly to different characteristics of the pancreatic stump. We describe five possible different PA that might be tailored to each different case, depending mainly on texture of pancreatic stump (soft/hard, lean/fatty) and the size and visibility of main duct. This manuscript presents a step-by-step portfolio of the most commonly used mini-invasive PA. This technique requires experience in pancreatic surgery and advanced minimally invasive skills. Knowledge of and proficiency in different types of PA could help reducing the incidence of postoperative pancreatic fistula.
Identifiants
pubmed: 36371550
doi: 10.1007/s13304-022-01389-0
pii: 10.1007/s13304-022-01389-0
doi:
Types de publication
Multicenter Study
Video-Audio Media
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
255-259Informations de copyright
© 2022. Italian Society of Surgery (SIC).
Références
Xu J, Ji SR, Zhang B et al (2018) Strategies for pancreatic anastomosis after pancreaticoduodenectomy: what really matters? Hepatobiliary Pancreat Dis Int 17:22–26
doi: 10.1016/j.hbpd.2018.01.012
Wang W, Zhang Z, Gu C et al (2018) The optimal choice for pancreatic anastomosis after pancreaticoduodenectomy: a network meta-analysis of randomized control trials. Int J Surg 57:111–116
doi: 10.1016/j.ijsu.2018.04.005
Hirono S, Kawai M, Okada KI et al (2019) Modified Blumgart mattress suture versus conventional interrupted suture in pancreaticojejunostomy during pancreaticoduodenectomy: randomized controlled trial. Ann Surg 269:243–251
doi: 10.1097/SLA.0000000000002802
Tewari M, Mahendran R, Kiran T et al (2019) Outcome of 150 consecutive Blumgart’s pancreaticojejunostomy after pancreaticoduodenectomy. Indian J Surg Oncol 10:65–71
doi: 10.1007/s13193-018-0821-z
Lyu Y, Li T, Cheng Y et al (2018) Pancreaticojejunostomy versus pancreaticogastrostomy after pancreaticoduodenectomy: an up-to-date meta-analysis of RCTs applying the ISGPS (2016) criteria. Surg Laparosc Endosc Percutan Tech 28:139–146
doi: 10.1097/SLE.0000000000000530
Huscher C, Perri G, Lazzarin C et al (2022) Coronary artery stent for securing high-risk pancreatico-jejunal anastomosis after pancreatoduodenectomy: a pilot series. Ann Surg 275:e665–e668
doi: 10.1097/SLA.0000000000005316