Schlanger Diana, Popa Călin, Ciocan Andra, Șofron Cornelia, Al Hajjar Nadim
Surgery Department, "Iuliu Haţieganu" University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania.
Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19-21, 400162 Cluj-Napoca, Romania.
J Clin Med. 2022 May 20;11(10):2891. doi: 10.3390/jcm11102891.
(1) Background: Emergency pancreatoduodenectomy (EPD) is a rare procedure, especially in non-trauma centers. Pancreatoduodenectomy is a challenging intervention, that has even higher risks in emergency settings. However, EPD can be a life-saving procedure in selected cases. (2) Methods: Our study is a single-center prospective consecutive case series, on patients that underwent emergency pancreatoduodenectomies in our surgical department between January 2014 to May 2021. (3) Results: In the 7-year period, 4 cases were operated in emergency settings, out of the 615 patients who underwent PD (0.65%). All patients were male, with ages between 44 and 65. Uncontrollable bleeding was the indication for surgery in 3 cases, while a complex postoperative complication was the reason for surgery in one other case. In three cases, a classical Whipple procedure was performed, and only one case had a pylorus-preserving pancreatoduodenectomy. The in-hospital mortality rate was 25% and the morbidity rate was 50%; the two patients that registered complications also needed reinterventions. The patients who were discharged had a good long-term survival. (4) Conclusion: EPD is a challenging procedure, rare encountered in non-traumatic cases, that can be a life-saving intervention in well-selected cases, offering good long-term survival.
(1) 背景：急诊胰十二指肠切除术（EPD）是一种罕见的手术，尤其是在非创伤中心。胰十二指肠切除术是一项具有挑战性的干预措施，在急诊情况下风险更高。然而，在特定病例中，EPD可能是挽救生命的手术。(2) 方法：我们的研究是一项单中心前瞻性连续病例系列研究，对象为2014年1月至2021年5月在我们外科接受急诊胰十二指肠切除术的患者。(3) 结果：在这7年期间，在615例行胰十二指肠切除术（PD）的患者中，有4例在急诊情况下接受了手术（0.65%）。所有患者均为男性，年龄在44岁至65岁之间。3例因无法控制的出血而进行手术，另1例因复杂的术后并发症而进行手术。3例患者接受了经典的Whipple手术，只有1例进行了保留幽门的胰十二指肠切除术。住院死亡率为25%，发病率为50%；发生并发症的2例患者还需要再次干预。出院的患者长期生存良好。(4) 结论：EPD是一项具有挑战性的手术，在非创伤性病例中很少见，但在精心挑选的病例中可能是挽救生命的干预措施，可提供良好的长期生存。
