Total pancreatoduodenectomy (TP) is the standard surgical approach for treatment of extended pancreas tumors. If the gastric coronary vein has to be sacrificed for oncologic or for technical reasons in total pancreatectomy with splenectomy, gastric venous congestion (GVC) may result because all major venous draining routes are terminated. In the sequelae of GVC, gastric venous infarction ultimately leads to gastric perforation with abdominal sepsis. To avoid gastric venous infarction, partial or even total gastrectomy is usually performed in the event of GVC after TP. However, this significantly impacts the patient's quality of life. Reconstruction of gastric venous outflow represents a technical approach to overcome GVC and to avoid gastric venous infarction making (partial) gastrectomy unnecessary. The current study aims to assess the role of gastric venous outflow reconstruction in GVC after TP to prevent (partial) gastrectomy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
20
Patients will be assigned to study after intraoperative evaluation of gastric venous drainage after coronary vein resection during TP, and the gastric venous outflow will be reconstructed after TP.
Surgery clinic
Heidelberg, Germany
Professor Dr. med. Arianeb Mehrabi
Heidelberg, Germany
Incidence of gastric venous congestion
Gastric venous congestion after gastric venous reconstruction following total pancreatectomy
Time frame: 30 days postoperative
Incidence of gastric ischemia
Gastric ischemia after gastric venous reconstruction following total pancreatectomy
Time frame: 30 days postoperative
Postpancreatectomy gastrectomy rate
Rate of gastrectomy after gastric venous reconstruction following total pancreatectomy
Time frame: 30 days postoperative
Reoperation rate
Reoperation rate after gastric venous reconstruction following total pancreatectomy
Time frame: 30 days postoperative
Morbidity rate
Complications rate after gastric venous reconstruction following total pancreatectomy
Time frame: 30 days postoperative
Mortality rate
Mortality rate after gastric venous reconstruction following total pancreatectomy
Time frame: 30 days postoperative
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