How to prevent the postoperative pancreatic fistula with an ethylene vinyl alcohol copolymer (OnyxⓇ) : A proposal of a new technique :A proposal of a new technique

Francesco Crafa; Francesco Esposito; Adele Noviello; Nicola Moles; Enrico Coppola Bottazzi; Carmelo Lombardi; Antonio Miro; Giulio Lombardi

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저자정보: Francesco Crafa (“St. Giuseppe Moscati” Hospital of National Relevance and High Specialty) Francesco Esposito (“St. Giuseppe Moscati” Hospital of National Relevance and High Specialty) Adele Noviello (“St. Giuseppe Moscati” Hospital of National Relevance and High Specialty) Nicola Moles (“St. Giuseppe Moscati” Hospital of National Relevance and High Specialty) Enrico Coppola Bottazzi (“St. Giuseppe Moscati” Hospital of National Relevance and High Specialty) Carmelo Lombardi (“St. Giuseppe Moscati” Hospital of National Relevance and High Specialty) Antonio Miro (“St. Giuseppe Moscati” Hospital of National Relevance and High Specialty) Giulio Lombardi (“St. Giuseppe Moscati” Hospital of National Relevance and High Specialty)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제22권 제3호

발행연도: 2018.8

수록면: 248 - 252 (5page)

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Backgrounds/Aims: Despite the advances in identifying risk factors, improving operative technique, and postoperative patient care, pancreatic leakage after pancreatic resection remains a highly debated topic. The aim of this study is to describe our technique and our initial experience with the intraoperative embolization of the main pancreatic duct with an Ethylene Vinyl Alcohol Copolymer (OnyxⓇ). Methods: Two patients of 63 and 64 years underwent pancreaticoduodenectomy for a cholangiocarcinoma of the extrahepatic bile duct and a pancreatic adenocarcinoma, respectively. At the time of pancreatic parenchyma resection, a Wirsung duct was identified and catheterized. A wirsungography was done and then, embolization with OnyxⓇ was carried out under fluoroscopic control. Results: Neither of the patients developed a postoperative pancreatic fistula. They were discharged to home on the 17th and 18th postoperative day, respectively. At the last follow-up, no recurrence was found. The two patients became diabetics; both needed the support of supplementary pancreatic enzymes. Conclusions: To our knowledge, we are the first to describe this technique, which seems safe and reliable. Studies on this subject with more patients are needed to confirm the validity of this procedure.

#Postoperative pancreatic fistula #Pancreaticoduodenectomy #Onyx< #SUP> #Ⓡ< #/SUP>

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