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Artigo Acesso aberto Produção Nacional Revisado por pares
BIBTEX RIS

Fístula pancreática após duodenopancreatectomia: correlação dos aspectos intra-operatórios e histologicos do pâncreas

2012; Brazilian College of Surgeons; Volume: 39; Issue: 1 Linguagem: Inglês

10.1590/s0100-69912012000100009

ISSN

1809-4546

Autores

Fernando Leal Pereira, Fernando Torres Vasques, André de Moricz, Tércio De Campos, Adhemar Monteiro Pacheco, Rodrigo Altenfelder Silva,

Tópico(s)

Pancreatitis Pathology and Treatment

Resumo

To evaluate the relationship between the occurrence of pancreatic fistula after pancreatojejunal anastomosis in patients undergoing pancreaticoduodenectomy for periampullary malignancy and the histological fibrosis and inflammation found in pancreatic tissue and the caliber of the main pancreatic duct.We conducted a retrospective study with patients that were treated with surgical resection. The rate of pancreatic fistulae was recorded. Histology classification was performed according to fibrosis and pancreatic inflammation.We identified 77 patients, mean age was 57.6 years; 62.4% were male. As for the type of operation performed, 66.3% were gastroduodenopancreatectomies and 33.7% pancreatoduodenectomies with pylorus preservation. Regarding the number of fistulas diagnosed, it was found that 23.4% patients displayed this postoperative complication and in 66.7% the cause was cancer of the papilla. As for intraoperative macroscopic findings, we identified the classification of pancreatic texture, seen as normal in 85.8%, and the caliber of the main pancreatic duct, finding an average of 4.9 mm. There was a significant relationship between the hardened pancreatic stump and the absence of fistula. In patients with normal or soft tissue, the rate of fistula was 25.4%. Regarding ductal diameter, we identified a higher number of pancreatic anastomotic dehiscences in the absence of ductal dilation (p <0.05). We noticed that patients with an average ductal diameter of 5.4 mm (76.7%) did not show this complication.The presence of fibrosis and ductal dilation usually coexist and is related to a lower percentage of pancreatic fistulae.

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