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Comparative analysis of afferent loop obstruction between laparoscopic and open approach in pancreaticoduodenectomy
Author(s) -
Song Ki Byung,
Yoo Daegwang,
Hwang Dae Wook,
Lee Jae Hoon,
Kwon Jaewoo,
Hong Sarang,
Lee Jong Woo,
Youn Woo Young,
Hwang Kyungyeon,
Kim Song Cheol
Publication year - 2019
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.656
Subject(s) - medicine , pancreaticoduodenectomy , surgery , complication , afferent , emergency surgery , gastroenterology , resection
Background Afferent loop obstruction ( ALO ) is a rare mechanical complication of pancreaticoduodenectomy ( PD ) and is associated with a high rate of morbidity and mortality. Methods Data from patients who underwent PD between May 2007 and July 2017 at a single large‐volume center were retrospectively reviewed. Results Of the 3,223 patients who underwent PD , 67 developed ALO . More patients in the laparoscopic PD ( LPD ) group had developed ALO due to internal herniation than did those in the ope n PD (OPD) group (46.2 vs. 4.7%, P < 0.001). Patients in the LPD group also showed earlier occurrence of ALO ( ALO occurrence within 60 days: 76.9 vs. 22.2%, P < 0.001) and more frequent requirement for surgical treatment (76.9 vs. 18.9%, P < 0.001) than did those in the OPD group. Conclusions The characteristics of ALO were significantly different between patients who had received LPD and OPD . The most common cause of ALO in the LPD group was internal herniation occurring in the early postoperative period. Internal herniation following LPD may be prevented by routine closure of mesocolic window and should be treated by emergency surgery if it occurs.