کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4279032 | 1611514 | 2013 | 8 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: The difficult hepaticojejunostomy after pancreatic head resection: reconstruction with a T tube The difficult hepaticojejunostomy after pancreatic head resection: reconstruction with a T tube](/preview/png/4279032.png)
BackgroundAfter pancreatic head resection, bile leaks from a difficult hepaticojejunostomy secondary to a small or fragile common hepatic duct may be reduced by a T tube at the side of the anastomosis.MethodsA retrospective analysis of patients who underwent a difficult hepaticojejunostomy without or with a T tube was performed.ResultsIn 48% (55/114) of patients, a T tube was placed at the side of the hepaticojejunostomy; 52% (59/114) did not have a T tube. Bile leaks occurred in 12% (14/114) (9% [5/55] in patients with a T tube vs 15% [9/59] without a T tube, P = .316). Bile leaks were associated with mortality, abscess formation, hemorrhage, and sepsis. Seven percent (8/114) of patients required revisional laparotomy (2% [1/55] with a T tube vs 12% [7/59] without a T tube, P = .036). Mortality was not different between the groups. Minor T-tube–associated complications occurred in 15% (8/55) without major complications.ConclusionsAugmentation of anastomosis with a T tube cannot prevent biliary leakage but does reduce the severity of bile leaks, resulting in less reoperations.
Journal: The American Journal of Surgery - Volume 206, Issue 4, October 2013, Pages 578–585