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Cho A, Katagiri S, Ota M, Onizawa S, Higuchi R, Sugishita T, Niwa Y, Ishita T, Mouri T, Kato A, Iwata M. No-touch isolation technique in emergency pancreaticoduodenectomy for neoplastic hemorrhage: Two case reports and review of literature. World J Gastrointest Surg 2024; 16:1910-1917. [PMID: 38983346 PMCID: PMC11230025 DOI: 10.4240/wjgs.v16.i6.1910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/08/2024] [Accepted: 04/30/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Emergency pancreaticoduodenectomy (EPD) is a rare event for complex periampullary etiology. Increased intraoperative blood loss is correlated with poor postoperative outcomes. CASE SUMMARY Two patients underwent EPD using a no-touch isolation technique, in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and duodenum. The operative times were 220 and 239 min, and the blood loss was 70 and 270 g, respectively. The patients were discharged on the 14th and 10th postoperative day, respectively. Thirty-two patients underwent EPD for the treatment of neoplastic bleeding. The mean operative time was 361.6 min, and the mean blood loss was 747.3 g. The complication rate was 37.5%. The in-hospital mortality rate was 9.38%. CONCLUSION The no-touch isolation technique is feasible, safe, and effective for reducing intraoperative blood loss in EPD.
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Affiliation(s)
- Akihiro Cho
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Satoshi Katagiri
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Masao Ota
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Shunsuke Onizawa
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Ryota Higuchi
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Toshiya Sugishita
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Yukiko Niwa
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Takeshi Ishita
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Toshihiko Mouri
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Akita Kato
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
| | - Moe Iwata
- Division of Gastroenterological Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center, Chiba 276-8524, Japan
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Popa C, Schlanger D, Chirică M, Zaharie F, Al Hajjar N. Emergency pancreaticoduodenectomy for non-traumatic indications—a systematic review. Langenbecks Arch Surg 2022; 407:3169-3192. [DOI: 10.1007/s00423-022-02702-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 10/04/2022] [Indexed: 11/25/2022]
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