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Abstract : Pancreaticoduodenectomy (PD) is the only potentially curative technique for managing head pancreatic cancer. The presenting symptoms of this disease often include jaundice. Surgery in jaundiced patients carries an increased risk of postoperative complications. Some experimental studies report beneficial effects of biliary drainage, but this benefit remains controversial in clinical studies. The aim of our first study was to examine the influence of preoperative biliary drainage on postoperative global and infectious complication after PD. PD was introduced and popularized by Whipple in 1935. Since then, many centres reported mortality rate less than 4% but morbidity rate remains high, about 50%. The aim of our second study was to determine which independent factors influence the development of pancreatic fistula and delayed gastric emptying after PD. PD in the elderly is still debated in the literature: is curative resection justified in the elderly given the high operative morbidity rates and the short life expectancies? The aim of our third study was to determine whether PD is associated with higher mortality and morbidity in patients' ≥ 70 years old. All this work allowed us to better comprehension of the consequences of PD. Moreover it is necessary for any surgeon to know the complications of any surgical procedure in order to prevent them and to inform the patient.
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Submitted on : Friday, May 2, 2014 - 3:30:47 PM
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  • HAL Id : tel-00986454, version 1


Emilie Lermite. CHIRURGIE PANCREATIQUE: EVALUATION ET REDUCTION DES RISQUES. Chirurgie. Université d'Angers, 2012. Français. ⟨NNT : ⟩. ⟨tel-00986454⟩



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