Successful treatment of multiple complications after pancreatoduodenectomy

Mushenko E.V.1, Tyshchenko O.M.1, Smachylo R.M.1, Starenkiy V.P.2, Avdosiev Yu.V.1

Summary. The rapid development of surgical pancreatology in the XXth century has led the basis for the development of different pancreatic resections, which are now successfully used to treat tumors and some non-neoplastic diseases of this organ. The main methodological aspects of the pancreatoduodenectomy (PD) were described in 1935 by Allen Oldfather Whipple. The next 9 decades were marked by the rapid development of anesthesiology, improvement of surgical techniques, development of new methods of instrumental support of surgical interventions, which led to a significant reduction in mortality, which in high-flow pancreatic centers does not exceed 3–5%. However, the number of postoperative complications is still extremely high and reaches up to 70%. The aim of this work is the demonstration of the effectiveness of a multidisciplinary approach in the treatment of multiple postoperative complications after PD, that are related with postoperative pancreatic fistula. This clinical observation demonstrates the effectiveness of a multidisciplinary approach in the treatment of multiple severe complications after PD. Only on-time diagnostics of complications, as well as the use of minimally invasive surgery make it possible to achieve a positive result of treatment in such cases. This all allows suggesting that pancreatic resections remains the prerogative of high-volume pancreatic centers.

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