Chowdappa Ramachandra, Tiwari Ajeet Ramamani, Ranganath Namrata, Kumar Rekha V
Department of Surgical Oncology, Kidwai Cancer Institute, Bengaluru, Karnataka, India.
Department of Anaesthesia and Pain Relief, Kidwai Cancer Institute, Bengaluru, Karnataka, India.
South Asian J Cancer. 2019 Apr-Jun;8(2):88-91. doi: 10.4103/sajc.sajc_241_18.
Pancreatic fistula has forever been a dreaded complication after pancreatic anastomosis (PA). We present a retrospective analysis of 10 years of experience with the Modified Heidelberg technique (MHT) that has been recently described.
The aim of the study is to establish postoperative pancreatic fistula (POPF) rates after MHT.
This is a retrospective observational study carried out at a tertiary cancer center in South India in the Department of Surgical Oncology.
Two hundred and eight consecutive patients who underwent pancreaticoduodenectomy (PD) and PA with MHT for a variety of proximal pancreatic lesions from January 2008 to February 2018 were included in this study. The incidence of POPF was recorded by the International Study Group on Pancreatic Fistula 2005 and 2016 definitions.
Epidemiological and clinical data are expressed in ratios and percentage and presented in table format.
Between January 2008 and March 2016, 186 patients underwent PD, and MHT was used for PA. Five (2.7%) patients developed Grade A POPF whereas Grades B and C were seen in three (1.6%) patients each with one death. Between April 2016 and February 2018, 22 patients underwent PD. Two patients (9%) had biochemical leak whereas none of them developed clinically relevant POPF. No deaths were recorded in this period. Overall, Grade B and Grade C POPF rates were 1.4% each, whereas 30-day mortality was 0.4%.
Results of this study indicate that MHT is a safe, reliable, easy to learn, and adopt technique of pancreatic reconstruction after PD.
胰瘘一直是胰肠吻合术后令人恐惧的并发症。我们对最近描述的改良海德堡技术（MHT）进行了为期10年的回顾性分析。
本研究的目的是确定改良海德堡技术（MHT）术后胰瘘（POPF）的发生率。
这是一项在印度南部一家三级癌症中心的外科肿瘤学部门进行的回顾性观察研究。
纳入2008年1月至2018年2月期间连续208例行胰十二指肠切除术（PD）并采用改良海德堡技术（MHT）进行胰肠吻合术治疗各种近端胰腺病变的患者。根据2005年和2016年国际胰瘘研究组的定义记录胰瘘发生率。
流行病学和临床数据以比率和百分比表示，并以表格形式呈现。
2008年1月至2016年3月，186例患者接受了胰十二指肠切除术，胰肠吻合采用改良海德堡技术（MHT）。5例（2.7%）患者发生A级胰瘘，而B级和C级胰瘘各有3例（1.6%），其中1例死亡。2016年4月至2018年2月，22例患者接受了胰十二指肠切除术。2例（9%）患者出现生化渗漏，但均未发生临床相关的胰瘘。此期间无死亡记录。总体而言，B级和C级胰瘘发生率均为1.4%，而30天死亡率为0.4%。
本研究结果表明，改良海德堡技术（MHT）是胰十二指肠切除术后一种安全、可靠、易于学习和采用的胰腺重建技术。
