Preemptive endoluminal vacuum therapy after pancreaticoduodenectomy: A case report  

作　　者：Flaubert Sena de Medeiros Epifanio Silvino do Monte Junior Romero de Lima França Heli Clóvis de Medeiros Neto Juliany Medeiros Santos Eligio Alves Almeida Júnior Samuel Oliveira da Silva Júnior Mario Herman Santos Moura Pedreira Tavares Eduardo Guimarães Hourneaux de Moura 

机构地区：[1]Department of Surgery,Federal University of Rio Grande do Norte,Natal 59012-300,Rio Grande do Norte,Brazil [2]Gastrointestinal Endoscopy Unit,Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,São Paulo 05403-000,Brazil [3]Department of Surgery,Hospital do Coração,Natal 59075-050,Rio Grande do Norte,Brazil [4]Gastrointestinal Endoscopy Unit,Faculty of Medicine of ABC,São Paulo 09190-615,Brazil [5]Department of Surgery,Instituto Juarez Almeida,Bacabal 65700-000,Maranhão,Brazil [6]Department of Surgery,Hospital Naval Marcílio Dias,Rio de Janeiro 20725-090,Rio de Janeiro,Brazil

出　　处：《World Journal of Gastrointestinal Endoscopy》2020年第11期493-499,共7页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Pancreaticoduodenectomy is a technically demanding operation,with reported morbidity rates of approximately 40%-50%.A novel idea is to use endoscopic vacuum therapy(EVT)in a preemptive setting to prevent anastomotic leakage and pancreatic fistulas.In a recent case series,EVT was proven to be effective in preventing leaks in patients with anastomotic ischemia.There have been no previous reports on preemptive EVT after pancreaticoduodenectomy.CASE SUMMARY We describe the case of a 71-year-old woman with hypertension and diabetes who was admitted to the emergency room with jaundice,choluria,fecal acholia,abdominal pain,and fever.Admission examinations revealed leukocytosis and hyperbilirubinemia(total:13 mg/dL;conjugated:12.1 mg/dL).Abdominal ultrasound showed cholelithiasis and dilation of the common bile duct.Magnetic resonance imaging demonstrated a stenotic area,and a biopsy confirmed cholangiocarcinoma. Considering the high risk of leaks after pancreaticoduodenectomy,preemptive endoluminal vacuum therapy was performed.The system comprised a nasogastric tube,gauze,and an antimicrobial incise drape.The negative pressure was 125 mmHg,and no adverse events occurred.The patient was discharged on postoperative day 5 without any symptoms.CONCLUSION Preemptive endoluminal vacuum therapy may be a safe and feasible technique to reduce leaks after pancreaticoduodenectomy.

关 键 词：PREEMPTIVE ENDOLUMINAL VACUUM PANCREATICODUODENECTOMY Case report 

分 类 号：R657.5[医药卫生—外科学]