Whipple procedure for trauma

Is duct ligation a safe alternative to pancreaticojejunostomy?

Larry M. Gentilello, Vicente Cortes, Kennan J. Buechter, Gerardo A. Gomez, Monica Castro, Robert Zeppa

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

The use of pancreatic duct ligation (DL) during a Whipple procedure for trauma has been reported but not analyzed. We reviewed 13 cases of DL and compared the results with that reported for the Whipple procedure for trauma with pancreaticojejunostomy (PJ). The mortality rate of DL was 53.8%. Pancreatitis occurred in three cases (23.1%) and caused one death. Pancreatic fistulae occurred in 50% of patients surviving two or more days after DL. No long-term survivor developed overt diabetes mellitus. Malabsorption occurred in 50% of the long-term survivors of DL. When the DL and PJ groups were compared no statistically significant difference could be found in either mortality or pancreatic morbidity. The 46.2% survival rate for DL warrants its consideration as a technique available to trauma surgeons when faced with an unstable patient unable to tolerate further operative therapy.

Original languageEnglish (US)
Pages (from-to)661-668
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume31
Issue number5
StatePublished - 1991

Fingerprint

Pancreaticojejunostomy
Ligation
Wounds and Injuries
Survivors
Pancreatic Fistula
Mortality
Pancreatic Ducts
Pancreatitis
Diabetes Mellitus
Survival Rate
Morbidity

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Gentilello, L. M., Cortes, V., Buechter, K. J., Gomez, G. A., Castro, M., & Zeppa, R. (1991). Whipple procedure for trauma: Is duct ligation a safe alternative to pancreaticojejunostomy? Journal of Trauma - Injury, Infection and Critical Care, 31(5), 661-668.

Whipple procedure for trauma : Is duct ligation a safe alternative to pancreaticojejunostomy? / Gentilello, Larry M.; Cortes, Vicente; Buechter, Kennan J.; Gomez, Gerardo A.; Castro, Monica; Zeppa, Robert.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 31, No. 5, 1991, p. 661-668.

Research output: Contribution to journalArticle

Gentilello, LM, Cortes, V, Buechter, KJ, Gomez, GA, Castro, M & Zeppa, R 1991, 'Whipple procedure for trauma: Is duct ligation a safe alternative to pancreaticojejunostomy?', Journal of Trauma - Injury, Infection and Critical Care, vol. 31, no. 5, pp. 661-668.
Gentilello, Larry M. ; Cortes, Vicente ; Buechter, Kennan J. ; Gomez, Gerardo A. ; Castro, Monica ; Zeppa, Robert. / Whipple procedure for trauma : Is duct ligation a safe alternative to pancreaticojejunostomy?. In: Journal of Trauma - Injury, Infection and Critical Care. 1991 ; Vol. 31, No. 5. pp. 661-668.
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abstract = "The use of pancreatic duct ligation (DL) during a Whipple procedure for trauma has been reported but not analyzed. We reviewed 13 cases of DL and compared the results with that reported for the Whipple procedure for trauma with pancreaticojejunostomy (PJ). The mortality rate of DL was 53.8{\%}. Pancreatitis occurred in three cases (23.1{\%}) and caused one death. Pancreatic fistulae occurred in 50{\%} of patients surviving two or more days after DL. No long-term survivor developed overt diabetes mellitus. Malabsorption occurred in 50{\%} of the long-term survivors of DL. When the DL and PJ groups were compared no statistically significant difference could be found in either mortality or pancreatic morbidity. The 46.2{\%} survival rate for DL warrants its consideration as a technique available to trauma surgeons when faced with an unstable patient unable to tolerate further operative therapy.",
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