By René Mantke, Hans Lippert, Markus W. Büchler, Michael G. Sarr
“International Practices in Pancreatic surgical procedure“ describes in nice element normal and particular technical points of the normal resection tactics of the pancreas. every one surgical step in the course of the pancreatic operation is strictly defined and followed by means of drawings and pictures. the most chapters on pancreatic carcinoma, continual and acute pancreatitis are written through the editors. a world college enhances the texts through describing their very own own thoughts. this idea bargains the best attainable review of the suggestions utilized by skilled surgeons.
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Extra resources for International Practices in Pancreatic Surgery
We perform >90 % of all head resections with preservation of the pylorus; a classic pancreatoduodenectomy procedure with antrectomy is limited to patients with tumor spread toward the pylorus, suspicious lymph nodes in this area, or a history of peptic ulcers. The incision is not standardized. A midline laparotomy is preferred in non-obese patients, because this incision provides a more comfortable exposure during the phase of pancreaticojejunostomy; however, in obese patients, a transverse incision offers better exposure during the resection.
The perioperative management of patients after distal pancreatectomy is similar to that after partial pancreatoduodenectomy in terms of perioperative, prophylactic antibiotics (mezlocillin or ciprofloxacin in case of penicillin allergy and metronidazole) and perioperative octreotide prophylaxis if the pancreas has a soft texture intraoperatively. The nasogastric tube inserted at the beginning of the operation is removed at the end of the operation. Oral intake of the patients is allowed on the first postoperative day with fluid, and the diet is advanced quickly.
Attention is then directed toward the hepatic pedicle. The bile duct, portal vein, right and left branches of the hepatic artery, hepatic artery, origin of the splenic artery, left gastric artery, and celiac trunk are skeletonized in order to remove not only the lymph nodes but all the nervous and lymphatic tissue as well (Fig. 2b). The right gastric artery is ligated and divided at its origin. both sides from its origin on the aorta to the root of the mesentery including a bilateral splanchnicectomy.
International Practices in Pancreatic Surgery by René Mantke, Hans Lippert, Markus W. Büchler, Michael G. Sarr