Duodeno-jejunal or gastro-enteric leakage after pancreatic resection: a case –control study

AbstractDuodeno-jejunal (DJ) and gastro-jejunal (GJ) anastomosis leakage represents a rare but life-threatening complication after pancreaticoduodenectomy or total pancreatectomy. The aim of this study was to assess its incidence, clinical presentation, and outcomes, and to identify perioperative risk factors for DJ/GJ leak. Prospectively collected perioperative data were reviewed, and a case –control study was performed. Patients who presented with a DJ/GJ leak (cases) were matched in a 1:5 ratio with patients who did not develop it. Match criteria included age, diagnosis, type of surgery, and anastomosis. Perioperative factors and outcomes were compared between groups. From January 2 008 to present, 13 cases were observed and compared to 60 controls. Concerning pre-operative variables, cases showed lower pre-operative serum hemoglobin (p = 0.021) and increased pre-operative radiotherapy (p = 0.037). Cases experienced more severe post-operative complications than Controls, according to the CD classification (p <  0.001), with a higher mortality rate (23% vs. 2%;p <  0.016). They also experienced a more demanding intra-operative course including an increased estimated blood loss (median 600 vs. 400 mL;p = 0.002), a higher rate of blood transfusion (n4 31% vs.n5 8%;p = 0.047) with also a longer operative time (median 360 vs. 318 min;p = 0.038). Moreover, the occurrence of a DJ/GJ leak was significantly associated with other post-operative complications:...
Source: Updates in Surgery - Category: Surgery Source Type: research