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KMID : 0870420110150040231
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2011 Volume.15 No. 4 p.231 ~ p.236
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Effectiveness of external drainage of the bile duct in pancreaticoduodenectomy: a single surgeon’s experience
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Yoon Jong-Hee
Kim Ki-Hun
Namgoong Jung-Man
Yoon Sam-Youl
Jung Sung-Won
Park Yo-Han
Park Hyung-Woo
Park Cheon-Soo
Lee Hyo-Jun
Park Do-Hyun
Lee Sang-Soo
Seo Dong-Wan
Lee Sung-Koo
Kim Myung-Hwan
Hwang Shin
Ahn Chul-Soo
Moon Deok-Bog
Ha Tae-Yong
Song Gi-Won
Jung Dong-Hwan
Park Gil-Chun
Lee Sung-Gyu
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Abstract
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Backgrounds/Aims: The rates of surgery-related complications during and after pancreaticoduodenectomy (PD) remain very high, reaching up to 41%. They were primarily caused by leakage of pancreatic juice. We evaluated the effectiveness of external drainage of the bile duct using a pigtail drain to prevent pancreatic leakage in patients undergoing PD.
Methods: We evaluated 79 patients who underwent PD using a single-layer continuous suture between the pancreatic parenchyma and jejunum after duct-to-mucosa anastomosis by a single surgeon from April 2005 to December 2008. Of the 79, 44 underwent external drainage (ED) of the bile duct using a pigtail drain, performed in the intraoperative field via a retrograde transhepatic approach, whereas 35 did not undergo ED.
Results: Age, sex distribution, number of total complications, pancreatic duct size, pancreatic texture and duration of hospital stay did not differ between patients who did and did not undergo ED. In groups with or without ED, 0 and 4 patients, respectively, showed leakage of pancreatic juice and the difference was statistically significant (p=0.02).
Conclusions: The fact that none of the patients who underwent external drainage experienced pancreatic leakage, suggests that external drainage of the bile duct with a pigtail drain to decompress the jejunum and to drain pancreatic and bile juice is useful in preventing the complications of pancreatic leakage.
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KEYWORD
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Pancreaticoduodenectomy, Pancreaticojejunostomy, Leakage
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