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Complications - Duodenohemipancreatectomy with Blumgart anastomosis and biliopancreatic separation

  1. Prevention and Management of Intraoperative Complications

    Bleeding/vascular injuries

    • V. portae/V. mesenterica superior → oversewing, partial resection and end-to-end suture
    • A. hepatica communis, dextra, sinistra → patch, partial resection and end-to-end suture

    Injury to the transverse mesocolon with perfusion disorder of the transverse colon

    • very rare → resection of the ischaemic bowel segment and end-to-end anastomosis

    Pancreatitis

    • very fragile, soft pancreas or assistance error → pressure damage caused by the retractor

    Unrecognised Dunbar syndrome

    • Compression syndrome of the truncus coeliacus by the median arcuate ligament of the diaphragm → the A. gastroduodenalis must not be divided! → division of the arcuate ligament

    Coagulation Damage to the Common Hepatic Duct (ischemic damage → later insufficiency)

    • CAVE: Electrocoagulation

    Injury to Organs

    • Immediate oversewing
    • Liver: rare bleeding or bile leak → electrocoagulation, liver suture
Prevention and Management of Postoperative Complications

Anastomotic leakage and pancreatic fistula are the main causes of postoperative morbidity and morta

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