Bibliographies thématiques / Fistola pancreatica

Littérature scientifique sur le sujet « Fistola pancreatica »

Auteur : Grafiati

Publié le 11 mars 2023

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Articles de revues sur le sujet "Fistola pancreatica"

Burgess, N. A., H. E. Moore, J. O. Williams et M. H. Lewis. « A Review of Pancreatico-Pleural Fistula in Pancreatitis and Its Management ». HPB Surgery 5, n^o 2 (1 janvier 1992) : 79–86. http://dx.doi.org/10.1155/1992/90415.

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Pancreatico-pleural fistula is a rare condition in which pancreatic enzymes drain directly in to the pleural cavity, most commonly from an enlarging pseudocyst. We review the literature on the causes, investigations and treatment of pancreatico-pleural fistulae and compare this with our own experience of the case of a 41 year old man with a left sided pancreatico-pleural fistula associated with pancreatic duct obstruction. The fistula could not be demonstrated by USS, CT or ERCP, and after these investigations the patient was managed conservatively. However, deterioration in the patients' condition led to an urgent but not emergency laparotomy and operative pancreatogram. This demonstrated the distally obstructed pancreatic duct, with associated pleural fistula for which aggressive surgical intervention was indicated. The patient subsequently completely recovered.

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Grobmyer, Stephen R., Darrell L. Hunt, Christopher E. Forsmark, Peter V. Draganov, Kevin E. Behrns et Steven N. Hochwald. « Pancreatic Stent Placement is Associated with Resolution of Refractory Grade C Pancreatic Fistula after Left-Sided Pancreatectomy ». American Surgeon 75, n^o 8 (août 2009) : 654–58. http://dx.doi.org/10.1177/000313480907500804.

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Pancreatic fistula have been a source of significant morbidity and mortality after left-sided pancreatectomy. The majority of fistulas are classified as Grade A and resolve quickly with no intervention. Grade C pancreatic fistulas, which require percutaneous or operative drainage, are less common and may be associated with morbidity and mortality. We used postoperative endoscopic pancreatic stent placement as an adjunctive strategy in the management of refractory Grade C pancreatic fistulas. Patients undergoing endoscopic pancreatic stent placement for persistent, refractory peripancreatic fluid collections/pancreatic fistula after left-sided pancreatectomy were identified. Eight patients underwent endoscopic pancreatic stent placement for refractory Grade C pancreatic fistulas. Six patients had percutaneous catheter placement; two patients had trans-gastric drainage. Endoscopic retrograde cholangiopancreatography (ERCP) showed extravasation of contrast from the distal end of the pancreatic duct in seven patients. Pancreatic stents were placed in all patients at a median time of 48 days postoperation and left for a median of 47 days. Before stent removal, ERCP demonstrated pancreatic fistula closure. Median time to complete resolution of the fistula was 41 days after stent placement. Endoscopic pancreatic stents were associated with resolution of Grade C fistulas. After distal pancreatectomy, pancreatic stent placement should be considered in the postoperative period for refractory pancreatic fistulas.

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Aziz, Hassan, Shahzaib Ahmad, Faisal S. Jehan, Wasif M. Saif et Syed Ahmad. « Management of Refractory Pancreatic Fistula : A Review of Literature ». Pancreas – Open Journal 5, n^o 2 (30 décembre 2022) : 23–27. http://dx.doi.org/10.17140/poj-5-117.

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Background Chronic non-healing or refractory pancreatic fistulae are rare complications of pancreatic surgery (pancreaticoduodenectomy, distal pancreatectomy) or pancreatitis. Materials and Methods We conducted a thorough literature search of electronic databases such as PubMed, Google Scholar, BioMed Central, and Cochrane Library using the keywords and medical subject headings (MeSH) terms “chronic pancreatic fistula”, “post-operative fistula”, “fistula management” and “refractory pancreatic fistula”. The purpose of this review is to evaluate the management options for refractory pancreatic fistula (PF). Results Literature reveals that refractory pancreatic fistulae have been managed by techniques like endoscopic ultrasound (EUS)-guided techniques like transmural puncture by clamping, puncture of the fistula tract, transmural placement of pigtail stent, and EUSguided pancreaticogastrostomy. Other techniques are postoperative endoscopic pancreatic stent placement in Grade C pancreatic fistula, intestinal decompression catheter insertion into the jejunum, embedding fistulojejunostomy, and fistulojejunostomy. Conclusion In conclusion, embedding fistulojejunostomy, EUS-guided transmural puncture by clamping, and EUS-guided transmural placement of pigtail stent are effective techniques for the management of refractory pancreatic fistulae. Yet further studies in a larger population are recommended.

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Barannikov, Anton Yu, Vladimir D. Sakhno, Vladimir M. Durleshter, Laura G. Izmailova, Andrei V. Andreev et Evgenii V. Tokarenko. « Differentiated approach to pancreatic-enteroanastomosis in pancreaticoduodenal resection : a clinical experimental controlled trial ». Kuban Scientific Medical Bulletin 28, n^o 5 (30 octobre 2021) : 29–46. http://dx.doi.org/10.25207/1608-6228-2021-28-5-29-46.

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Background. Despite decreasing mortality in pancreaticoduodenal resection, the incidence of postoperative complications in such patients remains high. The choice and formation of “reliable” pancreatic-enteroanastomosis remain relevant.Objectives. The improvement of immediate surgery outcomes in pancreaticoduodenal resection via development of a differentiated algorithm for pancreatic-enteroanastomosis formation.Methods. A prospective non-randomised controlled trial enrolled 90 patients with a pancreaticoduodenal resection surgery. The patients were divided in three cohorts, A (n = 30), B (n = 30) and control C (n = 30). Pancreatic shear wave ultrasound elastography was conducted pre-surgery in main cohorts A and B. Average parenchymal stiffness and intraoperative data decided between the two pancreatico-enteric anastomosis techniques, end-to-side or the original pancreatic-enteroanastomosis. Control cohort C had pancreatico-enteric anastomosis without taking into account the pancreas stiffness and macrocondition.Results. Class A postoperative pancreatic fistula was registered in 2 (6.7%) of 30 patients in cohort B; it was transient, asymptomatic, not requiring additional treatment or a longer postoperative period. No class B and C pancreatic-enteroanastomosis failures or stump pancreonecroses were observed in main cohorts A and B. Clinically significant class B and C postoperative pancreatic fistulae were registered in 5 (16.7%) of 30 patients in control cohort C (inter-cohort comparison statistically significant).Conclusion. The proposed differentiated approach to pancreatic-enteroanastomosis formation associates with a reliably low postoperative complication frequency and lack of clinically significant class B and C postoperative pancreatic fistulae.

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Valikhnovska, K. G. « Retrospective analysis of risk factors for occurrence of pancreatic fistula in patients following pancreaticoduodenectomy ». Reports of Vinnytsia National Medical University 22, n^o 3 (28 septembre 2018) : 436–41. http://dx.doi.org/10.31393/reports-vnmedical-2018-22(3)-07.

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Pancreaticoduodenectomy still is a “gold standard” in treatment of hepatopancreaticobiliary tumors. The causes of pancreatic fistula were analyzed in 414 patients aged from 22 to 81 following pancreaticoduodenectomy due to periampullary tumors. The said patients were operated on during the period from 2008 to 2017. The aim of this study is to improve outcomes of pancreatic resection based on a retrospective analysis of the causes of postoperative pancreatic fistulae and the development of a range of measures to prevent the above complication. Influence of risk factors of pancreatic fistula formation was evaluated by Pirson’s method (χ2). The factors contributing to the occurrence of pancreatic fistulas included type of resection (Whipple pancreaticoduodenectomy, pylorus preserving pancreaticoduodenectomy; χ2=8.616,1, p=0.0033, p<0.01), kind of pathology (cancer of the pancreatic head; χ2=7.658,1, p=0.0057, p<0.01), type of pancreaticojejunostomy (invaginative pancreatic duct-jejunostomy; χ2=17.83,1, p=0.0001, p<0.001) and technique for drainage of the major pancreatic duct (pancreaticojejunostomy on external drainage; χ2=16.40,1, p=0.0001, p<0.001). The detailed study of risk factors for the occurrence of pancreatic fistula is essential for improving the prognosis, prophylaxis and treatment of this pathology. The quality of the surgical intervention and the course of the postoperative period in patients with periampullary tumors depend on the choice of resection type, techniques for surgical interventions on the pancreas.

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Aswani, Yashant, Shehbaz MS Ansari, Ulhaas S. Chakraborty, Priya Hira et Sudeshna Ghosh. « Where there is pancreatic juice, there is a way : Spontaneous fistulization of severe acute pancreatitis-associated collection into urinary bladder ». Indian Journal of Radiology and Imaging 30, n^o 04 (octobre 2020) : 529–32. http://dx.doi.org/10.4103/ijri.ijri_349_20.

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AbstractPancreatic fluid collections (PFC) are notorious for their extension beyond the normal confines of the pancreatic bed. This distribution is explained by dissection along the fascial planes in retroperitoneum due to the digestive enzymes within the PFC. In genitourinary track, PFCs have been described to involve the kidneys and the ureters. We report a case of severe acute necrotizing pancreatitis in a 28-year-old male, chronic alcoholic, who on readmission developed features of cystitis. The urine was turbid but did not show significant bacteriuria. Close location of the PFC near the urinary bladder (UB) prompted evaluation of urinary lipase and amylase. Elevated urinary enzyme levels suggested a Pancreatico-vesical fistula, conclusive demonstration of which was established by CT cystography. Percutaneous drainage of the necrosum and stenting of pancreatic duct led to spontaneous healing of the pancreatico-vesical fistula. Our case reiterates the remarkable property of pancreatic enzymes to dissect the fascial planes which is demonstrated by decompression of PFC via UB causing spontaneous Pancreatico-vesical fistula. Further, presence of main pancreatic duct fistulization should prompt endoscopic-guided stenting to obliterate the communication with the fistula and accelerate healing.

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Ignjatovic, Dragan, Goran Kronja, Sidor Misovic et Dragan Mirkovic. « External transluminal drainage of the pancreatic duct due to fistula caused by postbioptic pancreatic necrosis ». Vojnosanitetski pregled 62, n^o 5 (2005) : 413–16. http://dx.doi.org/10.2298/vsp0505413i.

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Background. Pancreatic fistulas are not frequent after the needle biopsy of the pancreatic head. The aim was to present a patient with this type of fistula who was managed using the surgical method never previously applied in our surgical practice. Case report. In our patient, pancreatic fistula appeared at the site of the needle biopsies due to the development of the necrosis. Since the conservative treatment with octreotide and the total parenteral nutrition were without result, we turned to the surgical treatment by placing a silicone prosthesis along the pancreatic duct into the duodenum, next through the Roux-en-Y flexure to provide the external drainage of a pancreatic juice. Postoperatively, applying the conservative treatment, pancreatic fistula disappeared, and a silicone prosthesis was removed three weeks later. Conclusion. The described surgical procedure can be successful in managing fistulas which occur after the pancreatic necrosis.

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Tudor, A., C. Molnar, C. Nicolescu, C. Rosca, Bianca Tudor, V. O. Tudor et C. Copotoiu. « Cephalic Duodeno-Pancreatectomy with Pancreatic-Gastric Anastomosis with Double Purse String, in Patient with Lithiasis and Tumoral Jaundice - Case Report ». Acta Medica Marisiensis 60, n^o 5 (1 octobre 2014) : 227–30. http://dx.doi.org/10.2478/amma-2014-0047.

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Abstract Introduction: One of the most feared complications after cephalic duodeno-pancreatectomy remains pancreatic fistula. In recent years, various methods of pancreatico-digestive reconstruction were performed in order to reduce the rate of pancreatic fistula. One of these methods is pancreatico-gastric reconstruction by using two purse string threads. Case report: We present in this article a patient with jaundice with mixed etiology: tumoral and lithiasic. Subjectively, the patient accused sclerose-skin-jaundice, right upper quadrant and epigastric pain, nausea and vomiting. Computed tomography revealed dilatation of intraand extrahepatic bile ducts, a dilated Wirsung duct and a tumor at the biliopancreatic confluence, leading to a suspicion of vaterian ampulom. Upper endoscopy revealed a tumor protruding in the descending duodenal segment. Intraoperatively a tumor suggestive of vaterian ampulom and duct stones was shown. Surgical treatment consisted of coledocolitotomy, cephalic duodeno-pancreatectomy with pancreatic-gastric anastomosis, performed by using two purse string threads. The postoperative evolution was favorable. Conclusion: Pancreatico-gastric anastomosis using two purse string threads is a simple, safe and quick procedure, avoiding the application of sutures through the pancreatic parenchyma and thus reducing the rate of pancreatic fistula.

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Sguinzi, R., F. Pugin, C. Bader, A. Meyer, L. Buhler, L. Widmer, D. Staudenmann et B. Egger. « Massive Haematochezia due to Splenic Artery Bleeding into the Colon : Unusual Manifestation of Advanced Pancreatic Cancer ». Case Reports in Surgery 2023 (12 janvier 2023) : 1–5. http://dx.doi.org/10.1155/2023/7443508.

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We describe a case of an uncommon early pancreatic cancer presentation in a patient in his 60s who had haemorrhagic shock from extensive haematochezia and required blood transfusions as well as surveillance in an intensive care unit. A splenic artery pseudoaneurysm that had been effectively embolized by angiography was seen to be actively bleeding into the colon lumen on a computerized tomography (CT) scan along with a necrotic mass of the pancreatic tail. A pancreatic mucinous adenocarcinoma was diagnosed by a transgastric biopsy. A pancreatico-colic fistula was discovered by CT scan after a colic contrast enema. A transabdominal drainage of the necrotic collection and targeted antibiotic treatment had been performed with a satisfying patient outcome. In order to assess a potential secondary surgical resection, systemic chemotherapy was planned. In conclusion, haematochezia with hemodynamic instability originated from a splenic artery pseudoaneurysm fistulising into the colon (arterio-colic fistula) and sepsis originating from a tumoral pancreatic abscess fistulising into the colon (tumoral pancreatico-colic fistula).

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Tudor, A., C. Molnar, C. Copotoiu, VO Butiurca, C. Nicolescu, Tudor Bianca et Gurzu Simona. « Pancreatico-Gastric Anastomosis with and without Sutures – Experimental Swine Model ». Acta Medica Marisiensis 61, n^o 2 (1 juin 2015) : 105–9. http://dx.doi.org/10.1515/amma-2015-0032.

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Abstract Objectives. The aim of our study is to identify a surgical technical that has the lowest rate of pancreatic fistulas in pancreatico-gastric anastomosis following duodenopancreatectomies. We studied pancreatico-gastric anastomosis performed with stitches compared to the ones performed without stitches. Methods. Our experimental model is based on ten piglets, which were divided into 2 groups. In the first group (n=5) the pancreatico-gastric anastomosis was done using double purse-string threads one passed through the gastric seromuscular layer and one through the gastric mucosa. In the second group (n=5) the pancreatico-gastric anastomosis was performed using sutures through the stomach and pancreas. Results. Postoperative amylasemia was higher in the second group. In the first group no pancreatico-gastric fistulas were observed, whereas pancreatic necrosis was observed only at a superficial level of the pancreatic stump. In the second group, two cases had developed fistulas, both bordered by large areas of coagulation necrosis accompanied by pancreatic duct hyperplasia. Duration of the anastomosis was shorter for the first group. Conclusions. In conclusion, the pancreatico-gastric anastomosis performed using two purse-string suture is a feasible, safe and fast process.

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Thèses sur le sujet "Fistola pancreatica"

Abou, Khalil Jad. « Pancreatic fistulas after pancreatico-duodenectomies : are pancreatico-gastrostomies safer than pancreatico-jejunostomies ? a quasi-experiment and propensity-score adjusted analysis ». Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=122998.

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BACKGROUND Pancreatic fistula (PF) is a major contributor to morbidity and mortality after pancreaticoduodenectomy (PD). There remains a debate as to whether reestablishing pancreaticoenteric continuity through a Pancreatico-Gastrostomy (PG,) compared to a Pancreatico-Jejunostomy(PJ,) can decrease the risk of PF and total complications. GOAL: We compared the outcomes of patients undergoing PG or PJ after PD at the McGill University Health Centers, where patient assignment to PG or PJ fulfills most of the criteria for a Quasi-Experiment. METHODS Data on pre-operative factors and post- operative complications was collected for patients undergoing PD in our database between 1999 and 2011 and receiving either a PG or PJ reconstruction. We performed a propensity-score adjusted logistic regression to identify the effect of surgical technique on outcomes of PF, delayed gastric emptying (DGE), and total complications. We used the ISGPF and Strasberg and Linehan definition and classification for PF and the ISGPS definition for DGE. The total morbidity experience was assessed using the Clavien-Dindo classification and the Comprehensive Comorbidity Index (CCI) for all complications. RESULTS 23/103 and 20/103 (p=0.49) of patients had PF and 74/103 and 55/103 patients had all-grades DGE in the PG and PJ groups respectively (p=0.02). The groups did not differ with regards to Clavien-Dindo grade of complications (p=0.29) but did differ with regards to the CCI (38.4 vs. 31.4 for PG vs. PG respectively, p=0.02.) Propensity-score adjusted multivariate analysis showed no effect of surgical technique on PF (p=0.89), DGE grades B/C (p=0.9) or CCI (p=0.41) but there remained an effect on all-grades DGE (p=0.012.) CONCLUSION Patients undergoing PG reconstruction did not have less PF than those reconstructed with PJ after PD at our institution; Though Patients in both groups experienced a similar burden of complications, the odds of all- grade DGE were higher in the PG group.
CONTEXTE les fistules pacreatiques (PF) constituent une cause significative de la morbiditée et mortalité subie par les patients qui recoivent une pancreaticoduodenectomie (PD). La technique ideale pour retablir la continuité pancreatico-enterique est inconnue. Il n'est pas donné que les Pancreatico-Gastrostomies (PG) donne moi de PF et de complications post-operatives que les Pancreatico-Jejunostomies(PJ). BUT: Nous avons comparé le profile de complications post-operatoire chez les patients ayant subi une PG or PJ apres PD au Centre Universitaire de Sante McGill. METHODOLOGIE: Nous avons collecté des données pre-operatoires ainsi que les complications post- operatoires pour les patients ayant subi une PD dans notre base de données entre 1999 et 2011 et ayant subi une reconstruction par PG ou PJ. Nous avons performé une regression logistique ajustée pour un" propensity-score" pour identifier l'effet de la technique chirurgicale sur les PF, les delais de la motilitée gastrique (DGE), et les complications totales. nous avons utilisé les classifications ISGPF et Strasberg et Linehan pour PF et la definition ISGPS pour DGE. La morbidité totale a été evaluée par la classification Clavien-Dindo et l'Index Comprehensif de Morbidité (CCI). RESULTATS 23/103 et 20/103 (p=0.49) des patients ont developpé une PF et 74/103 et 55/103 patients ont eu DGE en periode post operatoire dans les groupes PG et PJ respectivement (p=0.02). Le grade Clavien-Dindo des complications n'etait pas different entre les groupes (p=0.29) mais le CCI l'etait (38.4 vs. 31.4 for PG vs. PG respectivement, p=0.02.) l'analyse multivariable ajustée pour le "Propensity-score" n'a pas montré d'effet de la technique chirurgical sur PF (p=0.89), DGE grades B/C (p=0.9) ou CCI (p=0.41) mais il restait un effet sur le DGE de toutes les grades de severité (p=0.012.) CONCLUSION Les patients ayant recu une PG n'avaient pas moins de PF que ceux ayant recu une PJ aprés PD a notre institution; Les deux groupes ont souffert du meme profile de complications, mais le groupe PG avait plus de DGE de toutes grades.

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Karjula, H. (Heikki). « Diagnosis, treatment and prophylaxis of pancreatic fistulas in severe necrotizing pancreatitis and the long-term outcome of acute pancreatitis ». Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526224312.

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Abstract Acute infected necrotizing pancreatitis (ANP) is a very complex disease with a high risk of complications and death. ANP is difficult to treat and is often associated with poor outcomes. Despite the increasing data on the technical details required to perform a mini-invasive necrosectomy for walled-off necrosis (WON), relatively few studies have focused on the presence and consequences of pancreatic duct disruption in the context of APN. Moreover, the long-term prognosis of patients with acute pancreatitis (AP) is scant. The aim of this study was to examine the diagnosis, treatment and prophylaxis of pancreatic fistulas (PFs) associated with APN. In addition, the long-term prognosis of AP was evaluated. The study population consists of the patients with AP treated at Oulu University Hospital, Finland (Studies I–IV) and Copenhagen University Hospital, Denmark (Study II) during 1995–2015. In the first part of the study, all consecutive patients following open necrosectomy for infected ANP were demonstrated to have PF. Endoscopic transpapillary pancreatic stenting (ETPS) was attempted and proven to be an effective and safe treatment for patients with PF. In Study II, prophylactic pancreatic stenting in the early stage of the disease was tested in a randomized controlled trial to the patients with ANP to prevent PFs associated with the disease. However, the study showed that the patients with ANP did not benefit from early prophylactic pancreatic ductal stenting (PPDS); instead, it seemed to be harmful for the patients. The results of Study III showed that single drain amylase level measurement after surgical necrosectomy is unreliable. According to this study, serial measurements are recommended to diagnose PFs after necrosectomy. Study IV including 1644 patients showed that AP, especially alcohol AP, was associated with a high long-term mortality. On the other hand, AP without an alcohol aetiology had a minimal impact on survival. In conclusion, in patients with infected ANP, a PF has to be considered in treatment, but the prevention of ductal leak with PPDS is not recommended. In addition, the poor long-term outcome among alcohol AP patients was due to alcohol-related diseases
Tiivistelmä Akuutti nekrotisoiva haimatulehdus ja erityisesti siihen liittyvä bakteeri-infektio on sairaus, johon liittyy korkea komplikaatio- ja kuolleisuusriski. Tautia usein komplisoi infektion lisäksi nekroosiin liittyvä haimafisteli, joka tekee hoidosta entistä haasteellisemman. Viime aikaisissa tutkimuksissa on käsitelty runsaasti mini-invasiivista nekrosektomiaa, mutta suhteellisen vähän on tutkimuksia nekrotisoivaan haimatulehdukseen liittyvästä fisteliongelmasta. Haimatulehdus-potilaiden pitkäaikaisennuste on myös epäselvä. Tämän väitöskirjatutkimuksen tavoitteena oli selvittää nekrotisoivaan haimatulehdukseen liittyvän haimafistelin yleisyyttä, diagnostiikkaa, ehkäisyä ja hoitoa. Lisäksi tarkasteltiin akuuttiin haimatulehdukseen sairastuneiden potilaiden pitkäaikaisennustetta. Ensimmäisessä osatyössä ilmeni, että kaikille potilaille, joille suoritettiin haiman nekrosektomia kehittyi fisteli ja endoskooppinen transpapillaarinen haimateiden stenttaus (ETPS) osoittautui hyväksi ja turvalliseksi hoidoksi fistelin hoidossa. Toisessa prospektiivisessa randomoidussa kontrolloidussa osatyössä tutkittiin profylaktista haimateiden stenttausta nekrotisoivassa haimatulehduksessa. Tutkimus osoitti, etteivät potilaat hyötyneet stenttauksesta: toimenpiteestä oli enemmän haittaa kuin hyötyä. Tämän tutkimuksen mukaan protetisointia ei suositella tehtäväksi taudin alkuvaiheessa. Kolmannessa osatyössä selvitettiin haiman nekrosektomian jälkeisen haimafistelin diagnosointia. Tutkimustuloksen mukaan haimafistelin osoittamiseksi dreenieritteen amylaasitasoa mittaamalla tarvitaan useita mittauskertoja, koska yksittäisen mittauksen sensitiivisyys on matala. Neljännessä osatyössä analysoitiin Oulun yliopistollisessa sairaalassa 1995–2012 akuutin haimatulehduksen sairastaneiden työikäisten potilaiden pitkäaikaisennustetta ja kuolinsyitä. Noin kymmenen vuoden seurannassa tutkimusryhmän (n = 1 644) kuolleisuus oli yli nelinkertainen verrattuna ikä- ja sukupuolivakioituihin verrokeihin (n = 8 220). Merkittävin kuolleisuutta lisäävä tekijä oli alkoholi. Tutkimuksemme osoitti, että infektoituneen haimanekroosiin liittyvä haimafisteli on huomioitava hoidossa. Varhaisesta profylaktisesta haimateiden protetisoinnista ei tutkimuksessa osoitettu olevan hyötyä. Alkoholin aiheuttaman haimatulehduksen pitkäaikaisennusteen mortaliteetti on korkea johtuen alkoholin käytöstä ja siihen liittyvistä sairauksista

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Castel, Marion. « Mise en forme et caractérisation de biomatériaux pour la prévention des fistules pancréatiques après pancréatectomies ». Thesis, Toulouse 3, 2017. http://www.theses.fr/2017TOU30193.

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Dans le cas d'une tumeur pancréatique, la chirurgie d'exérèse est le traitement de première intention lorsqu'elle est possible. Les pancréatectomies sont des actes à haut risque, entraînant un taux de morbidité de 50%. L'une des complications les plus graves est l'apparition de fistules pancréatiques (FP) qui surviennent dans 15 à 20 % des cas, pour lesquelles il n'existe aucune solution de prévention. Cette thèse porte sur l'élaboration d'un biomatériau pour la prévention des FP. Le cahier des charges, défini avec l'équipe chirurgicale, nous a orienté vers un dispositif médical sous forme de pansement absorbant, présentant des propriétés mécaniques adaptées, ainsi qu'une résistance aux enzymes pancréatiques serait intéressant. Un biomatériau constitué de deux couches a été imaginé : 1) une matrice absorbante constituée d'un complexe polyélectrolyte (PEC) sous forme de film, 2) une couche supérieure imperméable permettant de limiter la diffusion des enzymes pancréatiques dans le milieu péritonéal ; afin de répondre aux spécifications demandées par l'équipe médicale. La première partie de ce travail a porté sur l'optimisation de la mise en forme de la matrice sous forme de film à partir de PEC d'alginate (ALG) et de chitosane (CHI) présentant différents ratio de polymères (ALG-CHI 50/50 et ALG-CHI 63/37). L'influence de la technique d'homogénéisation des PEC, sous ultra-turrax (UT) ou au Stephan (ST) a été étudiée sur les propriétés physico-chimiques des films obtenus. Les propriétés de biodégradation, de gonflement et de cytotoxicité sont principalement influencées par le ratio des polymères. En revanche, leurs structure et propriétés mécaniques sont essentiellement influencées par la technique d'homogénéisation utilisée lors de l'élaboration du PEC. Au vu de ces résultats, le choix de la matrice au contact de l'anastomose ou de la tranche pancréatique s'est arrêté sur le PEC ALG-CHI 63/37 UT. La deuxième partie de cette thèse a été consacrée à l'incorporation d'une couche imperméable à la surface supérieure du film. Deux polymères ont été testés : l'acide polylactique (PLA) et le polycaprolactone (PCL). Ils ont été incorporés après fonctionnalisation de la surface du film. La matrice ALG-CHI 63/37 UT recouverte de PLA présente une surface plus hydrophobe, des propriétés mécaniques adaptées, une bonne résistance aux enzymes pancréatiques tout en possédant des propriétés de gonflement intéressantes. Le biomatériau ainsi obtenu est un bon candidat qui répond au cahier des charges d'un pansement indiqué pour la prévention des fistules pancréatiques
Resection surgery is the first-line treatment indicated for pancreatic tumor. The morbidity of this surgery is high with a complication rate around 50%. One of the most serious complications is the occurrence of pancreatic fistula (PF), which occurs in 15-20% of cases. To date, no biomaterial available on the market is indicated for the prevention of the onset of PF following pancreatectomy. This project focuses on the development of a biomaterial for the prevention of PF. Specifications identified by the surgical team oriented us to ward an absorbent dressing with sufficient mechanical properties and pancreatic enzymes resistance. A biomaterial made up of two layers was designed: 1) an absorbent matrix, in the form of a film, constituted by a polyelectrolyte complex (PEC), 2) an impermeable backing layer expected to limit the diffusion of the pancreatic enzymes into the peritoneal medium; to meet surgeons' specifications. The first part of this work focused on the optimization of the preparation of the matrix, composed of alginate (ALG) and chitosan (CHI) PECs films with different polymer ratios (ALG-CHI 50/50and ALG-CHI 63/37). The influence of the technique of homogenization of PEC, ultra-turrax (UT) or Stephan (ST) was studied on the physicochemical properties of the films. Biodegradation, swelling and cytotoxicity were shown to be mainly influenced by the ratio of polymers used. On the other hand, structure and mechanical properties are mainly influenced by the homogenization technique. With these results, the choice of the matrix to pancreatic application was set as the PEC ALG-CHI 63/37 UT. The second part of the present work was devoted to the incorporation of an impermeable backing layer on the upper film surface. Two polymers were evaluated: polylactic acid (PLA) and polycaprolactone (PCL). They were incorporated after the functionalization of the film surface. The PLA-coated ALG-CHI 63/37 UT matrix led to more hydrophobic surfaces, as well as adaptated mechanical properties and resistance to pancreatic enzymes with interesting swelling properties. The obtained biomaterial is a promising candidate responding to the specifications for a dressing indicated for the prevention of PF

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RINALDI, YVES. « Fistules pancreatico-bronchiques ». Aix-Marseille 2, 1989. http://www.theses.fr/1989AIX20806.

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Uchida, Yuichiro. « Clinical and experimental studies of intraperitoneal lipolysis and the development of clinically relevant pancreatic fistula after pancreatic surgery ». Kyoto University, 2020. http://hdl.handle.net/2433/253140.

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NAM, HAI YIN. « Fistule wirsungo-portale au cours des pancreatites chroniques calcifiantes : a propos d'un cas et revue de la litterature ». Amiens, 1992. http://www.theses.fr/1992AMIEM123.

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Lubrano, Jean. « Facteurs pronostiques et thérapeutiques après traitement chirurgical de l'adénocarcinome du pancréas céphalique ». Thesis, Normandie, 2017. http://www.theses.fr/2017NORMC422/document.

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Le 17 novembre 2016 a eu lieu la 3ème journée mondiale de lutte contre le cancer du pancréas.Cette prise en considération tardive rend compte de la dualité entre une incidence faible et un pronostic redoutable. Sa réputation de cancer rapidement mortel est attestée par un ratio incidence/mortalité proche de 1. Au 10ème rang en termes de localisations de cancers, il se hisse au 4ème rang en termes de mortalité par cancer et devrait devenir, en 2020, la 2ème cause de décès par cancer devant le cancer du côlon et juste après le cancer du poumon. Le taux de survie à 5 ans, tous stades confondus, est de 5% aux USA et en Europe.L’adénocarcinome canalaire pancréatique représente la tumeur la plus fréquente (80% des tumeurs pancréatiques exocrines). Sa localisation dans la glande pancréatique est céphalique dans 2/3 des cas.A ce jour, le traitement chirurgical reste le seul traitement potentiellement curatif. Celui-ci ne s’adresse qu’à une faible proportion de patients. En effet, seul 20% des patients présentant un adénocarcinome pancréatique céphalique sont effectivement résécables permettant d’obtenir un taux de survie globale à 5 ans d'environ 10 à 20% si la résection est suivie de chimiothérapie adjuvante ou non. Ces résultats modestes sont en outre à pondérer par la morbi-mortalité des résections pancréatiques céphaliques. Dans la série de l’Association Française de Chirurgie, reprenant les résections pancréatiques céphaliques réalisées en France entre 2004 et 2010, la mortalité était de 3,8% et la morbidité de 54%. Parmi les complications post-opératoires, la fistule pancréatique représente la principale complication en termes de mortalité (15 à 25%), génératrice de coût important dans les soins et d’une augmentation significative de la durée de séjour. La fistule pancréatique demeure la pierre angulaire de l’amélioration du pronostic des patients.L’objectif de ce travail sur l’adénocarcinome canalaire pancréatique céphalique traité chirurgicalement était d’analyser certains facteurs influençant la morbi-mortalité au trois temps de sa prise en charge :- Avant l’intervention, avec l’étude d’un facteur pronostic préopératoire, sur une cohorte de patients, pouvant influencer la survenue d’une fistule pancréatique et la mortalité- Pendant l’intervention, avec la réalisation d’une méta-analyse sur le type de reconstruction pancréatique et son influence sur la survenue d’une fistule pancréatique- Après l’intervention, avec l’étude de l’influence de la survenue d’une complication sévère sur la survie et la survie sans récidive.Au cours de cette thèse nous avons vu, que la réduction du taux de fistule pancréatique, par le seul biais de techniques peropératoires semble difficilement réalisable au regard de la multiplicité des techniques et de la difficulté à réaliser des études randomisées contrôlées méthodologiquement satisfaisantes. En revanche, la recherche des facteurs liés aux patients, prédisposant à la survenue d’une fistule pancréatique semble l’approche à privilégier. Ceci est d’autant plus primordial dès lors que nous avons mis en évidence un lien entre la survenue d’une complication sévère et la survie ou la récidive chez les patients réséqués. Ce travail souligne l’importance d’être capable d’identifier, dès la consultation, les patients à haut risque de complications sévères et de fistule post-opératoire d’une part, pour sélectionner les bons candidats à la chirurgie et d’autre part, pour être capable de leur apporter une information franche et loyale indispensable éthiquement au consentement éclairé
The third World Day on pancreatic cancer took place the 17th November 2016. This late consideration is due to the duality between his relative scarcity and a dreadful prognosis.Its aggressiveness is underlined by a mortality rate equal to its incidence. Ranked 10th on cancer-related localization and 4th on cancer-related mortality, he will become the second cause of cancer-related deaths in 2020 just behind pulmonary cancer and before colorectal cancer. 5-yr survival rate is 5% irrespective of the stage.Pancreatic ductal adenocarcinoma is the most frequent form (80% of exocrine pancreatic tumors). He is localized in cephalic pancreas in 2/3 of cases.Although pancreatic resection provides the only chance of long-term survival, no more than 20% of patients will be eligible for surgery in curative intent leading to a 5-yr survival rate of 10 to 20%. Pancreaticoduodenectomy for pancreatic head, neck and uncinated process is still a challenging procedure. In the study of the French Surgery Association, mortality and morbidity rate were respectively 3.8% and 54%. Postoperative pancreatic fistula is considered as the Achilles’ heel of pancreaticoduodenectomy and is associated with increased post-operative mortality. Postoperative pancreatic fistula generates significant costs and prolonged hospital stay. Thus postoperative pancreatic fistula is the corner stone of patient’s prognosis improvement.The aim of this study on operated pancreatic ductal adenocarcinoma was to analyze several factors influencing morbidity and mortality.- Before surgery, by testing the impact of body surface area in a cohort of patients.- During surgery, by conducting a meta-analysis on reconstruction methods for pancreatic anastomosis.- After surgery, by evaluating the influence of severe complications on survival and recurrence.We show that the use of various surgical refinements, such as type of pancreatic anastomoses, are equivocal to decrease postoperative pancreatic fistula rate and that performing randomized controlled trials will be difficult. In contrast, the search for patient’s factors leading to postoperative pancreatic fistula seems to be the promising approach. This is of major concern as we demonstrated the causal link between the occurrence of severe postoperative complications and survival or recurrence. This work highlights the need for surgeons to distinguish during preoperative consultation high-risk patients in order to select the best candidates suitable for surgery as well as to give them a full and frank information ethically necessary for free and informed consent

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Gaspar, Alberto Facury. « Impacto nos resultados assistenciais e nos custos hospitalares do emprego do selante de fibrina na anastomose pancreatojejunal após ressecção duodenopancreática ». Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/17/17157/tde-28072015-143625/.

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Introdução: Os benefícios do emprego do selante de fibrina no reforço de anastomoses pancreatico-jejunais, após ressecção duodenopancreática, visando a redução da incidência de fístula pancreática pós operatória (FPPO), ainda são questionáveis. Objetivo: Avaliar a influência do emprego do selante de fibrina na anastomose pancreatico-jejunal, após duodenopancreatectomia, na incidência de fístula, bem como suas consequências clínicas e os custos hospitalares. Metodologia: Estudo retrospectivo de 62 pacientes consecutivos submetidos a duodenopancreatectomia, divididos em dois grupos: 31 pacientes utilizando o selante de fibrina (GCS) e 31 pacientes sem o emprego de selante (GSS). As variáveis estudadas foram agrupadas em epidemiológicas, clínicas, laboratoriais, com destaque para a incidência de fístula pancreática, classificada segundo a definição do International Study Group on Pancreatic Fistula, suas complicações pós operatórias catalogadas segundo a classificação de Clavien e suas repercussões na assistência e nos seus custos avaliados pelo método de absorção com rateio simples de todas as despesas, exceto a despesa com medicamentos, tratada de forma separada. Resultados: Os grupos foram homogêneos para os parâmetros epidemiológicos, clínicos, e laboratoriais e não foram registradas diferenças significativas na comparação da evolução pós operatória e dos indicadores assistenciais hospitalares. Por outro lado, os custos hospitalares foram mais elevados no GCS, em relação ao GSS (p<0,0001). Conclusão: O emprego do selante de fibrina, no reforço da anastomose pancreatico-jejunal, em pacientes submetidos a duodenopancreatectomias, nas condições estudadas, não melhorou os resultados clínicos e assistenciais e ainda aumentou os custos hospitalares.
Introduction: The benefits of fibrin sealant employment in strengthening pancreatico-jejunal anastomosis after duodenopancreatic resection, reducing the incidence of pancreatic fistula postoperative (PFPO) are still questionable. Objective: To evaluate the influence of the use of fibrin sealant in pancreatico-jejunal anastomosis after pancreaticoduodenectomy in the incidence of fistula and its clinical consequences and hospital costs. Methodology: A retrospective study of 62 consecutive patients who underwent pancreaticoduodenectomy, divided into two groups: 31 patients using fibrin sealant (GCS) and 31 patients without the sealant employment (GSS). The variables were grouped into epidemiological, clinical, laboratory, especially the incidence of pancreatic fistula classified as defined by the International Study Group on Pancreatic Fistula, their postoperative complications cataloged according to Clavien rating and its repercussions on care and its costs assessed by the absorption method with simple apportionment of all expenses except the expenditure on medicines, treated separately. Results: The groups were homogeneous for clinical, epidemiological and laboratory parameters and no significant differences were recorded in the comparison given postoperative progress and hospital assistance indicators. Moreover, hospital costs were higher in GCS, with respect to GSS (p <0.0001). Conclusion: The use of fibrin sealant in pancreatojejunal anastomosis after pancreaticoduodenectomy, in the studied conditions, did not improve the results of care and also increased hospital costs

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Martinell, Tina. « Tidiga tecken på pankreasanastomosläckage efter kirurgi : en studie om hur dessa kan upptäckas med hjälp av ett bedömningsformulär ». Thesis, Röda Korsets Högskola, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-81.

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Bakgrund: Pankreatikoduodenektomi är den enda kurativa behandlingen av pankreascancer och pankreasanastomosläckage (PAL) är en mycket allvarlig postoperativ komplikation. Metoder för att identifiera detta i ett tidigt skede behöver förbättras. Den postoperativa övervakningen består till stor del av vitalparametrar men sjuksköterskan observerar även andra tecken på försämring. Metod: 32 patienter som genomgått pankreatikoduodenektomi inkluderades i studie. Ett bedömningsformulär innehållande 14 parametrar togs fram och användes för att identifiera vad i sjuksköterskans observationer som kan identifiera tidiga tecken på PAL. Studien hade kvantitativ ansats. Syfte: Att identifiera tidiga tecken på PAL efter pankreatikoduodenektomi med hjälp av ett bedömningsformulär. Resultat: Bedömningsformuläret identifierade normalförloppet efter pankreatikoduodenektomi. Vid jämförelse mellan patienterna som drabbats av PAL och normalförloppet urskildes tre signifikanta skillnader. Patienterna med PAL hade innan det diagnostiserades ökat syrgasbehov, sjuksköterskan bedömde deras allmäntillstånd som dåligt istället för ganska gott och patienternas egenbedömning av allmäntillståndet visade att de mådde sämre för varje dag istället för bättre. Slutsatser: Studien indikerar att ökat syrgasbehov samt sjuksköterskans bedömning och patientens egenbedömning av allmäntillståndet är vägledande för upptäckten av pankreasanastomosläckage.
Background: Pancreaticoduodenectomy is the only curative treatment of pancreaticcancer and postoperative pancreatic fistula (POPF) is a very serious complication. Methods to identify this in an early stage must be improved. The postoperative monitoring is largely composed of vital signs, but the nurse also observes other signs of deterioration. Method: 32 patients how underwent pancreaticoduodenectomy were included in the study. An assessment form containing 14 parameters was used to identify what in the nurse's observation that can identify early signs of POPF. The study had a quantitative approach. Objective: To identify early signs of POPF after pancreaticoduodenectomy using anassessment form. Results: The assessment form identified the normal process after pancreaticoduodenectomy. In the comparison between the patients affected by POPF and the normal process, three significant differences were distinguished. The patients with POPF had before it occurred increased oxygen needs, the nurse assessed the general health as poor rather than pretty good and the patients self-assessed the general health worse by the day instead of better. Conclusions: This study indicates that increased oxygen needs and the nurse's assessment and the patient's self-assessment of general health can be indicative for the discovery of POPF.

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MALLEO, Giuseppe. « STUDIO PROSPETTICO MULTICENTRICO SULLA GESTIONE DEI DRENAGGI DOPO DUODENOCEFALOPANCREASECTOMIA UTILIZZANDO UN SISTEMA DI STRATIFICAZIONE DEL RISCHIO ». Doctoral thesis, 2016. http://hdl.handle.net/11562/939513.

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Obiettivo: Questo studio multicentrico ha valutato prospetticamente un protocollo di gestione dei drenaggi chirurgici dopo duodenocefalopancreasectomia (DCP) basato sulla combinazione del concetto di drenaggio selettivo (in base a stratificazione del rischio) e di rimozione precoce dei drenaggi stessi. Background: Recenti evidenze scientifiche suggeriscono che sia il posizionamento selettivo di drenaggi sia la loro rimozione precoce risultino applicabili nella DCP. Entrambe le strategie, prese singolarmente, sono state associate a una diminuzione dell'incidenza di fistola pancreatica clinicamente rilevante, la complicanza più comune e allo stesso tempo più critica dopo DCP. Metodi: Il protocollo è stato applicato a 260 pazienti consecutivi operati in un periodo di 17 mesi nelle due istituzioni partecipanti. Il rischio di sviluppare fistola pancreatic clinicamente rilevante è stato stimato attraverso il calcolo intraoperatorio del fistula risk score (FRS). I drenaggi non sono stati posizionati nei pazienti con FRS 0-2, mentre sono stati posizionati per FRS >=3. Nei pazienti con drenaggio, è stato ottenuto in prima giornata postoperatoria ll valore di amilasi dal liquido del drenaggio stesso, che è stato successivamente rimosso in terza giornata se il valore era <=5000 U/L. I pazienti con amilasi dal drenaggio >5000 U/L sono stati gestiti a discrezione del chirurgo che aveva il paziente in carico. I risultati sono stati comparati con una coorte storica (N=557; 2011-2014). Risultati: il FRS non è risultato diverso tra le due coorti (Mediana: 4 vs. 4; p=0.933). Non si è sviluppata alcuna fistola clinicamente rilevante nei 70 pazienti con FRS=0-2, nei quali i drenaggi non erano stati posizionati. L'incidenza di fistola clinicamente rilevante è risultata significativamente minore dopo l'implementazione del protocollo (11.2 vs 20.6%, p=0.001). Nella coorte sperimentale è anche stata osservata minore incidenza di complicanze severe, reinterventi, e posizionamento di drenaggi percutanei (tutte le p<0.05). Anche la degenza mediana è stata minore nella coorte sperimentale (8 vs. 9 giorni, p=0.001). Non c'è stata differenza nell'incidenza di fistole biliari e chilose. Conclusione: Il posizionamento di drenaggi può essere evitato in un quarto dei pazienti sottoposti a DCP. Nei pazienti in cui il drenaggio è posizionato, Il dosaggio delle amilasi in prima giornata postoperatoria identifica in quali la rimozione precoce del drenaggio stesso è appropriata. Questo approccio stratificato per rischio ha ridotto significativamente l'incidenza di fistola pancreatica.
Objective: This multicenter study sought to prospectively evaluate a drain management protocol for pancreatoduodenectomy (PD). Background: Recent evidence suggests value for both selective drain placement and early drain removal for PD. Both strategies have been associated with reduced rates of clinically relevant pancreatic fistula (CR-POPF) – the most common and morbid complication following PD. Methods: The protocol was applied to 260 consecutive PDs performed at two institutions over 17 months. Risk for ISGPF CR-POPF was determined intra-operatively using the Fistula Risk Score (FRS); drains were omitted in negligible/low risk patients and drain fluid amylase (DFA) was measured on POD1 for moderate/high risk patients. Early drain removal (POD3) occurred for patients with POD1 DFA ≤5000 U/L, while patients with POD1 DFA >5000 U/L were managed by clinical discretion. Outcomes were compared with a historical cohort (N=557; 2011-2014). Results: Fistula risk did not differ between cohorts (Median FRS: 4 vs. 4; p=0.933). No CR-POPFs developed in the 70 (29.4%) negligible/low risk patients. Overall CR-POPF rates were significantly lower following protocol implementation (11.2 vs 20.6%, p=0.001). The protocol cohort also demonstrated lower rates of severe complications, any complication, reoperation, and percutaneous drainage (all p<0.05). These patients also experienced reduced hospital stay (8 vs. 9 days, p=0.001). There were no differences between cohorts in bile or chyle leaks. Conclusion: Drains can be safely obviated for one-quarter of PDs. Drain amylase analysis identifies which moderate/high risk patients benefit from early drain removal. This data-driven, risk-stratified approach has significantly decreased the occurrence of clinically relevant pancreatic fistula.

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Livres sur le sujet "Fistola pancreatica"

P, Pederzoli, Bassi C et Vesentini S, dir. Pancreatic fistulas. Berlin : Springer-Verlag, 1992.

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Pederzoli, Paolo, Claudio Bassi et Sergio Vesentini, dir. Pancreatic Fistulas. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8.

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Bassi, C., Paolo Pederzoli et S. Vesentini. Pancreatic Fistulas. Springer London, Limited, 2012.

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Chapitres de livres sur le sujet "Fistola pancreatica"

Pulvirenti, Alessandra, Giorvanni Marchegiani, Antonio Pea, Roberto Salvia et Claudio Bassi. « Pancreatic Fistula ». Dans Pancreatic Cancer, 317–27. Berlin, Heidelberg : Springer Berlin Heidelberg, 2017. http://dx.doi.org/10.1007/978-3-662-47181-4_30.

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Illner, W. D., H. Schneeberger, D. Abendroth, R. Landgraf, M. Gokel et W. Land. « Pancreatic Fistulas in Pancreatic Transplantation ». Dans Pancreatic Fistulas, 91–99. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_7.

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Bockman, D. E. « Functional Anatomy of the Pancreas : The Ductal System ». Dans Pancreatic Fistulas, 1–9. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_1.

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Bassi, C. « Microbiological Aspects of Pancreatic Fistulas ». Dans Pancreatic Fistulas, 121–28. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_10.

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Martini, N., S. Vesentini, C. Bassi, M. Falconi, R. Girelli, A. Messori et P. Pederzoli. « Antibiotics Secretion into Pancreatic Fluid ». Dans Pancreatic Fistulas, 129–39. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_11.

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Vantini, I., C. Scattolini et A. Fioretta. « Artificial Nutrition in Pancreatic Fistulas ». Dans Pancreatic Fistulas, 140–45. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_12.

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Pederzoli, P., M. Falconi, C. Bassi, L. Benetti et G. F. Briani. « Drugs Inhibiting Exocrine Pancreatic Section ». Dans Pancreatic Fistulas, 146–54. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_13.

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Nifosi, F., M. Falconi, E. Montresor et S. Vesentini. « Limitations of Conservative Therapy of Pancreatic Fistulas ». Dans Pancreatic Fistulas, 155–61. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_14.

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Falconi, M., F. Nifosi, D. Lombardi, C. Bassi et R. Girelli. « Pitfalls of Medical Treatment ». Dans Pancreatic Fistulas, 162–66. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_15.

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Büchler, M., H. Frieß et H. G. Beger. « The Use of Octreotide to Prevent Postoperative Complications After Major Pancreatic Resection ». Dans Pancreatic Fistulas, 167–75. Berlin, Heidelberg : Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77418-8_16.

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Actes de conférences sur le sujet "Fistola pancreatica"

Clark, K., et K. E. Gross. « Pancreatico-Pleural Fistula and Pancreatico-Pericardial Fistula : Unusual Complications of Pancreatitis ». Dans American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6439.

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Mangas, C., J. Martínez, L. Compañy, FA Ruiz, JA Casellas et J. Ramón Aparicio. « PANCREATIC RENDEZVOUS THROUGH LUMEN-APPOSING STENT IN A PATIENT WITH PANCREATICO-PLEURAL FISTULA ». Dans ESGE Days 2018 accepted abstracts. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1637284.

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Unger, J., P. Bagley, N. Huprikar et D. Mabe. « Gastronomic Pleurisy : A Case of Pancreatic Pleural Fistula ». Dans American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3257.

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Lapshyn, H., E. Petrova, L. Bolm, L. Frohneberg, D. Bausch, T. Keck et U. Wellner. « Simple radiological parameters predict postoperative pancreatic fistula in pancreatoduodenectomy ». Dans Viszeralmedizin 2019. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1695222.

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von Ehrlich-Treuenstätt, V., M. Ilmer, D. Clevert, H. Niess, J. D’Haese, S. Ormanns, F. Klauschen, M. Angele, J. Werner et B. Renz. « Preoperative Ultrasound Elastography (SWE) predicts increased risk of Pancreatic Fistula (POPF) after pancreaticoduodenectomy ». Dans Viszeralmedizin 2021 Gemeinsame Jahrestagung Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Sektion Endoskopie der DGVS, Deutsche Gesellschaft für Allgemein und Viszeralchirurgie (DGAV). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1733601.

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Oroomchi, N., H. N. Boakye-Wenzel, M. Kung et J. P. Kilburn. « A Rare Case of Pleurodesis Achieved with Bilateral Tunneled Pleural Catheters in a Patient with Pancreatic-Pleural Fistula ». Dans American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3256.

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Ali, EA, M. Camus, S. Leblanc, F. Paye, P. Balladur, JC Vaillant, F. Menegaux et al. « ENDOSCOPIC MANAGEMENT OF POSTOPERATIVE PANCREATIC FISTULAS (POPF) ARISING AFTER DISTAL PANCREATECTOMY OR ENUCLEATION : A TERTIARY CARE CENTER EXPERIENCE ». Dans ESGE Days. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1704230.

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Sozzi, G., C. Cicero, A. Fagotti, M. Petrillo, S. Domingo, V. Lago, R. Berretta et al. « EP1224 Predictors and clinical outcome of pancreatic fistula in patients receiving splenectomy for advanced or recurrent ovarian cancer : a large multicentric experience ». Dans ESGO Annual Meeting Abstracts. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/ijgc-2019-esgo.58.

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Wiltberger, G., M. den Dulk, F. Pedersoli, A. Andert, J. Bednarsch, Z. Czigany, F. Ulmer et U. Neumann. « Flow relevant stenosis of the celiac artery is an independent risk factor for postoperative pancreatic fistula : results of a retrospective, multicentre, international cohort study ». Dans Viszeralmedizin 2021 Gemeinsame Jahrestagung Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Sektion Endoskopie der DGVS, Deutsche Gesellschaft für Allgemein und Viszeralchirurgie (DGAV). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1733602.

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