Pancreatogastrostomy after Pancreaticoduodenectomy in Cirrhotic Patient with Portal Hypertension a Case Report

Alejandra Salazar-Álvarez, Javier López-Gómez, Mario Álvarez-Bojórquez, Noel ZaragozaCruz and Alejandro E. Padilla-Rosciano

Department of Oncologic Surgery, National Cancer Institute, Mexico City, Mexico
Surgical Department of Gastrointestinal Tumors, National Cancer Institute, Mexico City, Mexico

^*Correspondance to: Alejandra Salazar-�lvarez 

 PDF  Full Text DOI: 10.25107/2474-1647.1602

Abstract

Introduction: There is a few evidence in literature about pancreaticoduodenectomy in cirrhotic patients, increase mortality, morbidity and complications, there is no published evidence about the role of pancreaticogastrostomy reconstruction.Case: We present a patient who underwent a PD with pancreaticogastrostomy reconstruction by a pancreatic cancer of the head, he was operated whit Child – Pugh A, in the postoperative evolution, present bleeding episodes that merited two endoscopic and one surgical interventions. Once recovered he has continued in vigilance without complications.Discussion: The surgical time was longer as well as wound complications in 14%, internal hemorrhage in 6% vs. 2%, pancreatic fistula in 19% vs. 10% and hospital mortality 12% vs. 1.6% the median survival was 19 month vs. 24 months in no cirrhotic patients, the rate of complications in general is 46% vs. 22% in no cirrhotic patients.Conclusion: There is no contraindication to do the PD in cirrhotic patients in Child Pugh A including patients with portal hypertension in specialized centers, but we don´t recommend the reconstruction with pancreatogastrostomy in this cases.

Keywords

Cite the article

Salazar-�lvarez A, L�pez-G�mez J, �lvarez-Boj�rquez M, Zaragoza-Cruz N, Padilla-Rosciano AE. Pancreatogastrostomy after Pancreaticoduodenectomy in Cirrhotic Patient with Portal Hypertension a Case Report. Clin Surg. 2017; 2: 1602.