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. 2015 Mar;6(1):6-15.
doi: 10.1007/s13193-013-0286-z. Epub 2014 Jan 19.

Pancreatoduodenectomy - preventing complications

Prasanth Penumadu  1 , Savio G Barreto  2 , Mahesh Goel  1 , Shailesh V Shrikhande  3
Affiliations

Pancreatoduodenectomy - preventing complications

Prasanth Penumadu et al. Indian J Surg Oncol. 2015 Mar.

Abstract

Increased awareness of periampullary & pancreatic head cancers, and the accompanying improved outcomes following pancreatoduodenectomy (PD), has possibly led to an increase in patients seeking treatment for the same. While there has definitely been a reduction in morbidity rates following PD in the last few decades, this decline has not mirrored the drastic fall in mortality. Amongst the foremost in the factors responsible for this reduction in mortality is the standardization of surgical technique and development of dedicated teams to manage all aspects of this demanding procedure. This review intends to provide the reader with an overview of major complications following this major surgery and measures to prevent them based on the authors' experience.

Keywords: Classification; Complications; Haemorrhage; Pancreatic fistula; Pancreatoduodenectomy; Prevention.

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Figures

Fig. 1
Fig. 1
a CECT showing pseudoaneurysm of the common hepatic artery (arrow in red), referred to the hospital a year after PD—An unusual presentation. b Celiac angiogram with post coil & glue embolization (arrow in red) of pseudoaneurysm followed by stent graft placement (arrow in black) shows exclusion of pseudoaneurysm with flow maintained in the hepatic artery
Fig. 2
Fig. 2
Hepaticojejunostomy—anterior and posterior wall parachuting sutures ensuring duct to mucosa approximation
See this image and copyright information in PMC

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