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Heterotopic pancreas autotransplantation with spleen for uncontrollable hemorrhagic pseudocyst and disabling pain in chronic pancreatitis.
- Source :
-
Hepato-gastroenterology [Hepatogastroenterology] 2013 May; Vol. 60 (123), pp. 425-7. - Publication Year :
- 2013
-
Abstract
- Background/aims: In this study, we report on a heterotopic segmental pancreatic autotransplantation (HPAT) with spleen for alcoholic chronic pancreatitis with uncontrollable hemorrhagic pseudocyst and complete portal venous obstruction. The patient was a 72-year-old man who had an alcoholic chronic pancreatitis with severe abdominal pain and hemorrhagic pseudocyst. The first bleeding from a pseudoaneurism of the gastro-duodenal artery (GDA) to the cyst of pancreas head was stopped by interventional radiology (IVR) at our hospital on May 2010. The second bleeding happened with severe abdominal pain on February 15th, 2011; he was admitted on February 17. The IVR was not successful.<br />Methodology: There were two problems for the operation. The first was the severe inflammation and the second was the control of hemorrhage from GDA. We were afraid of the postoperative hemorrhage due to the leakage of pancreatic juice in the pancreato-duodenectomy (PD). Therefore, we chose the HPAT as a solution for postoperative hemorrhage and severe abdominal pain. After complete duodeno-pancreatectomy with spleen, we performed HPAT with spleen on March 8, 2011. The pancreatic duct reconstruction was performed by Roux-en-Y anastomosis to the jejunum.<br />Results: The postoperative course was uneventful. The abdominal pain had resolved completely and the patient remained normoglycemic after HPAT.<br />Conclusions: We conclude that HPAT is a useful option for hemorrhagic pseudocyst of the pancreas head with severe abdominal pain of chronic pancreatitis.
- Subjects :
- Abdominal Pain diagnosis
Abdominal Pain etiology
Aged
Anastomosis, Roux-en-Y
Constriction, Pathologic
Disability Evaluation
Humans
Jejunum surgery
Male
Pain Measurement
Pancreatic Ducts surgery
Pancreatic Pseudocyst diagnosis
Pancreatic Pseudocyst etiology
Pancreaticoduodenectomy
Pancreatitis, Alcoholic complications
Pancreatitis, Alcoholic diagnosis
Pancreatitis, Chronic complications
Pancreatitis, Chronic diagnosis
Portal Vein surgery
Postoperative Hemorrhage diagnosis
Postoperative Hemorrhage etiology
Predictive Value of Tests
Plastic Surgery Procedures
Splenectomy
Tomography, X-Ray Computed
Transplantation, Autologous
Treatment Outcome
Abdominal Pain surgery
Pancreas Transplantation methods
Pancreatic Pseudocyst surgery
Pancreatitis, Alcoholic surgery
Pancreatitis, Chronic surgery
Postoperative Hemorrhage surgery
Spleen transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 0172-6390
- Volume :
- 60
- Issue :
- 123
- Database :
- MEDLINE
- Journal :
- Hepato-gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 23159354
- Full Text :
- https://doi.org/10.5754/hge12805