Functional, biological, and radiological evaluation of the pancreaticojejunal anastomosis 1 year after pancreatoduodenectomy: a prospective study.
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22 août 2023
- doi: 10.1007/s00423-023-03040-x
- issn: 1435-2443
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info:eu-repo/semantics/altIdentifier/doi/10.1007/s00423-023-03040-x
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info:eu-repo/semantics/altIdentifier/pmid/37606699
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info:eu-repo/semantics/altIdentifier/eissn/1435-2451
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info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_C879F27CE20A0
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Pancreatoduodenectomy Duodenopancreatectomy Whipple's procedureCiter ce document
G.R. Joliat et al., « Functional, biological, and radiological evaluation of the pancreaticojejunal anastomosis 1 year after pancreatoduodenectomy: a prospective study. », Serveur académique Lausannois, ID : 10.1007/s00423-023-03040-x
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This prospective study aimed to analyze the functional, biological, and radiological aspects of the pancreatic anastomosis 1 year after pancreatoduodenectomy (PD). From 2016 to 2019, patients with PD indication were screened. Questionnaires about pancreas insufficiency, fecal elastase tests, and magnetic resonance imaging (MRI) were performed before and 1 year after PD. Twenty patients were prospectively included. The only difference between pre- and postoperative questionnaires was constipation (less frequent 1 year after PD). Median pre- and postoperative fecal elastase levels were 96 μg/g (IQR 15-196, normal value > 200) and 15 μg/g (IQR 15-26, p = 0.042). There were no significant differences in terms of main pancreatic duct (MPD) size (4, IQR 3-5 vs. 4 mm, IQR 3-5, p = 0.892), border regularity, stenosis, visibility, image improvement, and secondary pancreatic duct dilation before and after secretin injection. All patients but one (2 refused and 2 were lost to follow-up, 15/16, 94%) had a patent pancreaticojejunal anastomosis on 1-year MRI. Although median 1-year fecal elastase was significantly lower than preoperatively, suggesting that exocrine secretion was altered, the anatomical outcome as assessed by MRI was excellent showing high patency rate (15/16, 94%) at 1 year. This emphasizes the difference between anatomy and function.