Abstract
OBJECTIVE: The authors used prolamine (Ethibloc, Ethicon GmBH, Norderstedt, Germany) for segmental obstruction of the pancreatic duct to prevent pancreatic fistula development after distal pancreatectomy combined with total gastrectomy for gastric malignancies. SUMMARY BACKGROUND DATA: Although the initial clinical application of prolamine was pancreatic duct obstruction for patients with pancreatitis and undergoing pancreatic transplantation and pancreaticoduodenectomy for pancreatic cancer, there are no reports on prevention of pancreatic fistula formation after distal pancreatectomy. METHODS: Prolamine (0.2 mL) was injected into the distal segment of the main duct in the remaining pancreata of 51 patients. Small pancreatic ducts on the cut surface, from which prolamine extravasates, were closed by ligation, the main duct was ligated doubly, and the transected pancreatic margin was closed 15 minutes after phenylpropanolamine hydrochloride injection. RESULTS: No patient developed a pancreatic fistula or the complication of arterial bleeding due to prolonged infection. CONCLUSION: Segmental obstruction of the pancreatic duct with prolamine is useful for preventing pancreatic fistula development after distal pancreatectomy.
Full text
PDF





Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adamsbaum C., Kalifa G., Seringe R., Dubousset J. Direct Ethibloc injection in benign bone cysts: preliminary report on four patients. Skeletal Radiol. 1993;22(5):317–320. doi: 10.1007/BF00198389. [DOI] [PubMed] [Google Scholar]
- Bücheler E., Hupe W., Klosterhalfen H., Altenähr E., Erbe W. Neue substanz zur therapeutischen Embolisation von Nierentumoren. Rofo. 1978 May;128(5):599–603. doi: 10.1055/s-0029-1230912. [DOI] [PubMed] [Google Scholar]
- Dubernard J. M., Traeger J., Neyra P., Touraine J. L., Tranchant D., Blanc-Brunat N. A new method of preparation of segmental pancreatic grafts for transplantation: trials in dogs and in man. Surgery. 1978 Nov;84(5):633–639. [PubMed] [Google Scholar]
- Fortner J. G., Lauwers G. Y., Thaler H. T., Concepcion R., Friedlander-Klar H., Kher U., Maclean B. J. Nativity, complications, and pathology are determinants of surgical results for gastric cancer. Cancer. 1994 Jan 1;73(1):8–14. doi: 10.1002/1097-0142(19940101)73:1<8::aid-cncr2820730104>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
- Herbreteau D., Riche M. C., Enjolras O., Khayata M., Lemarchand-Venencie F., Borsik M., Brette M. D., Reizine D., Merland J. J. Percutaneous embolization with Ethibloc of lymphatic cystic malformations with a review of the experience in 70 patients. Int Angiol. 1993 Mar;12(1):34–39. [PubMed] [Google Scholar]
- Jaschke W., Hoevels J. Control of hepatic tumor hemorrhage by transcatheter embolization with Ethibloc. Acta Radiol. 1988 Jan-Feb;29(1):15–19. [PubMed] [Google Scholar]
- Land W., Gebhardt C., Gall F. P., Weitz H., Gokel M. J., Stolte M. Pancreatic duct obstruction with prolamine solution. Transplant Proc. 1980 Dec;12(4 Suppl 2):72–75. [PubMed] [Google Scholar]
- Land W., Landgraf R., Illner W. D., Abendroth D., Kampik A., Jensen U., Lenhart F. P., Burg D., Hillebrand G., Castro L. A. Clinical pancreatic transplantation using the prolamine duct occlusion technique--the Munich experience. Transplant Proc. 1987 Aug;19(4 Suppl 4):75–83. [PubMed] [Google Scholar]
- Lundell L., Grip I., Olbe L. Pancreatic resection additional to gastrectomy for gastric cancer. Effect on postoperative morbidity. Acta Chir Scand. 1986 Feb;152:145–149. [PubMed] [Google Scholar]
- Papachristou D. N., Fortner J. G. Pancreatic fistula complicating pancreatectomy for malignant disease. Br J Surg. 1981 Apr;68(4):238–240. doi: 10.1002/bjs.1800680406. [DOI] [PubMed] [Google Scholar]
- Takagi K., Nishi M., Kajitani T. Surgical treatment of gastric cancer today. Wien Klin Wochenschr. 1987 Jun 12;99(12):410–415. [PubMed] [Google Scholar]
- Tokutake S., Kotani K., Saito K., Yamaji N. Syntheses of 2-chloro-4-nitrophenyl beta-D-maltopentaosides with bulky modification and their application to the differential assay of human alpha-amylases. Chem Pharm Bull (Tokyo) 1992 Sep;40(9):2531–2536. doi: 10.1248/cpb.40.2531. [DOI] [PubMed] [Google Scholar]
- Wittrin G., Jost J. O., Clemens M., Arndt M. Pankreasgangocclusion nach partieller Duodenopankreatektomie in der Carcinomchirurgie. Chirurg. 1981 Mar;52(3):157–159. [PubMed] [Google Scholar]



