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KMID : 0371319660080080445
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Journal of the Korean Surgical Society
1966 Volume.8 No. 8 p.445 ~ p.451
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Pancreatic surgery Experience in 52 operations on the pancreas at Severance Hospital Y.U.M.C.
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許景渤/Hur, Kyung Bal
李景植/金鍾根/李允錫/閔珖植/Lee, Kyung Sik/Kim, Chong Kun/Lee, Yoon Suk/Min, Kwang Sik
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Abstract
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Recent adbances in the knowledge of the patho-physiology of the pancreas have been associated wih an increasing amount of pancreatic surgery. This is a report of our experience in 45 patients who had 52 operations between January, 1960 and July, 1966.
Pancreatico-duodenectomy(Whipple´s operation) was performed on nine patients for the following diagnosis: carcinoma of the common bile duct-2, of the Ampulla of Vater-3, in the head of the pancreas-1, in the hepatic flexure of the colon-1. One patient suspected of having a Zollinger-Ellison syndrome, and one having a leiomyosarcoma of the descending duodenum are also included.
A caudal resection of the pancrease was done nine times as a part of an en-bloc resection of gastric carcinoma in the cardia. (Grimes procedure)
In 21 patients te pancreatic duct was cannulated in an attempt to prevent postoperative pancreatitis. Twice the pancreatic duct orifice was dilated because it was stenotic.
Diagnostic pancreatography was carried out on five patients to help in evaluation of the condition of the pancreatic duct.
There were 4 deaths among the 45 patients and 52 operations. Three of the deaths occurred after pancreatico-duodenectomy(33%). The fourth followed an exploratory laparotomy done in a patient who was found to have hemorrhagic shock and an associated pancreatitis. The pathologic diagnosis for the syndrome(suspect). It is felt that a reduction in mortality rate could be obtained by a very careful selection of candidates for the operation of pancreatico-duodenostomy.
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