Stenosis of pancreaticogastrostomy after pancreaticoduodenectomy (a case report)

Abstract

Formation of the pancreaticodigestive anastomosis after pancreaticoduodenectomy (PD) is the “Achilles’ heel” of this operation. Early postoperative complications are well known and well described in the scientific literature, but there are few works on late postoperative complications. Stenosis of pancreaticodigestive anastomoses are rarely mentioned, and the vast majority of publications are focused on stenosis of pancreaticojejunostomy. Regarding stenosis of pancreaticogastrostomy, there are only a few publications of clinical cases in the English-language literature. The aim of the work was to analyze the case of stenosis of pancreaticogastrostomy after PD. Results. The article presents a clinical case of pancreaticogastrostomy stenosis in a patient 5.5 months after PD. The study included the analysis of inpatient and outpatient charts, data of clinical, laboratory and instrumental examinations. Features of the pancreaticogastrostomy formation in clinic are listed, complaints of the patient during the development of stenosis are revealed, results of additional methods of diagnostics and also operative treatment – neopancreaticogastrostomy that was carried out are described in detail. Conclusions. Stenosis of pancreaticogastrostomy is a rare and little-studied late complication of pancreaticoduodenectomy. The clinical course of the pancreaticogastrostomy stenosis, the results of laboratory and instrumental methods did not allow to state with certainty the diagnosis of acute pancreatitis. The formation of neopancreaticogastrostomy is the operation of choice for the described pathology treatment.