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Emergency Kausch-Whipple procedure: indications and experiences.

Jens Standop, Tim Glowka, Volker Schmitz, Nico Schaefer, Andreas Hirner, and Jörg C Kalff

Pancreas 39(2):156-9 (2010) PMID 20182309

OBJECTIVE: Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. METHODS: Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. RESULTS: Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. CONCLUSIONS: Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

DOI: 10.1097/MPA.0b013e3181bb98d2
Version: za2963e q8za4 q8zba q8zcc q8zdc q8zed q8zfd q8zg3
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