Abstracts / Pancreatology 14 (2014) S1eS129S116

Conclusion: Pancreatoduodenectomywithportal vein resection and leftrenal grafting is a safe procedure without risk of renal failure. During CT acollateral flow through left ovarian veinwere observed. The left renal vein isan adequate vessel for grafting because of relatively easy access with a goodchance to obtain a vessel of suitable length and vessel diameter.

F-100.

Three continuous suction drainages to avoid severe pancreatic fistulain patients with soft pancreas after pancreaticoduodenectomy

Seiji Yamagishi a, Satoshi Mizutani a, Hideyuki Suzuki a, Takayuki Aimoto b,Akira Muraki a, Ryosuke Nakata a, Eiji Uchida c

a Institute of Gastroenterology, Nippon Medical School MusashikosugiHospital, JapanbKobayashi Hospital, JapancDepartment of Surgery, Nippon Medical School, Japan

Background: Pancreatic fistula (PF) is a possible cause of fatal com-plication. Adequate drainage after pancreaticoduodenectomy (PD) canprevent from increasing severity.

Aims: The Aim of this study is to verify practical effectiveness of threecontinuous suction drainages after PD.

Patients & methods: This is a retrospective review of 34 patients whounderwent PD for periampullary cancer. The remnant pancreas showed asoft texture in all cases.

Reconstruction was undertaken with Child procedure. And duct-to-mucosa anastomosis (sub-total diversion) was used in pan-creaticojejunostomy (PJ). PF was diagnosed according to the InternationalStudy Group for Pancreatic Fistula (ISGPF). All patients (n¼34) were divi-ded into 2 groups. Group1 (n¼14) patients having drainage tubes behindthe foramen of Winslow and dorsal space of PJ, Group2 (n¼20): patientshaving an additional tube in caudal space of left lobe of liver. We comparedpostoperative pancreatic fistula (POPF) severity, additional treatment andmortality between these groups.

Results: There were no differences in the background of the twogroups. Eleven patients developed into PF. Incidence of grade B and C POPFin group1 and 2 was 50% and 19% respectively. Seven of 14 patients ingroup1 complicated pancreatic fistula and 4 patients required ultrasonic-guided percutaneous drainage. Notably, all abscess site spread in caudalspace of left lobe of liver. Although 4 patients in group2 developed into PF,they required only anti-biotic drug.

Conclusion: Three adequate continuous drainages can prevent POPFafter PD from developing into fatal complication.

F-101.

Surgical treatment of malignant tumors of the head of the pancreasand periampullary region

Igor Khomiak, Volodimir Kopchak, Kostyantin Kopchak, OlexandrDuvalko, Andrii Khomiak

National institute of surgery and transplantology named after O.O.Shalimov, Department of pancreatic and bile ducts surgery, Ukraine

Background: The problem of surgical treatment of malignant tumors ofthe periampullary region (MTPR) is a key-point in modern pancreatology.

Aims: To improve the results of surgical treatment in patients withMTPR by development and implementation of new surgical techniques

Patients & methods: We have analyzed the results of 412 pan-creaticoduodenectomies (PD) in patients with periampullary malignanciesin the period of 2001-2011 years. In 296 patients standard Whipple pro-cedurewas performed, in 116 patients with malignancies of papilla of Vateror distal part of bile duct pylorus-preserving PD was preferred. We per-sonalized our surgical strategy and implemented modern techniques. In 26patients additional vascular resections were performed. In 30 patients weimplemented no-touch PD.

Results: Postoperative morbidity was 29,5%, postoperative mortality-2,7%. Median survival was 24, 38, 72 months in patients with pancreaticcancer, bile duct cancer and cancer of papilla of Vater correspondingly.Affection of the portal/superior mesenteric vein is indication for PD withresection and reconstruction of the vessel. Implementation of the PD withpreservation of the gastroduodenal artery and dorsal pancreatic arterymadeit possible to decrease the rate of postoperative complications to 14,8%.Implementation of the technique of PD with selective ligation of inferiorpancreaticoduodenal artery decreased the rate ofmean intraoperative bloodloss. Implementation of new techniques increased resectability rate on 23,8%and decreased postoperative mortality from 4,9% to 2,7%.

Conclusion: Development and implementation of new methods ofsurgical treatment of MTPR allow to decrease complications rate andimprove results of treatment of such a complex category of patients.

F-102.

Depression in pancreatic cancer

Dorota Zielinska a, Marek Durlik b

a Central Hospital of the Ministry of Interior in Warsaw, ClinicalDepartment of Gastrointestinal Surgery and Transplantation, Polandb Central Hospital of the Ministry of Interior in Warsaw, ClinicalDepartment of Gastrointestinal Surgery and Transplantation, PAN,Poland

Background: The connection between depression and pancreaticcancer has been studied for over 30 years. Patients with depression haveless favorable life expectancy and worse quality of life. However it remainsunknown whether depression heightens the risk of pancreatic cancer orthe cancer evokes depressive symptoms.

Aims: The aim of this study was to evaluate the connection between asurgical treatment and an occurrence of depression among patients withpancreatic cancer after a radical treatment.

Patients&methods: In the study groupwere included 17 patients withthe diagnosis of pancreatic cancer that underwent the radical surgicaltreatment (R0 resection). The first comparison group comprised the 13patients with pancreatic cancer after the palliative resection. The secondcomparative group comprised 26 patients operated because of pancreatictumor with the diagnosis other than pancreatic cancer. Patients werehospitalized in Clinical Department of Gastrointestinal Surgery andTransplantation in the period from 1 July 2010 to 30 June 2011. Everypatient was evaluated with the Beck Depression Inventory (BDI) beforesurgery and 1, 6, 12 months after surgery.

Results: Depression incidence rates with BDI before surgery and 1, 6, 12months after surgery respectively:

Experimental group: 53%, 60%, 50%, 43%.1 comparative group: 54%, 58%, 59%, 63%.2 comparative group: 45%, 58%, 51%, 50%.Conclusion: Our preliminary data indicate that the surgical treatment

decreases the incidence of depressive disorder among patients after theradical surgical treatment.