Clinical Study
Reoperation following Pancreaticoduodenectomy
Table 4
Indications for late reoperations.
| | Indications | Number of patients | Surgery performed | Interval between PD and re-operation |
| | Group 1 | | | | | Incisional hernia | 4 | Mesh hernioplasty | 8–68 months | | Pancreatico-jejunostomy stricture | 2 | Revision PJ/PG | 31/36 months | | Adhesive SAIO | 2 | Band release | 16/96 months | | HJ stricture | 1 | Revision HJ | 29 months | | Persistent gastroparesis | 1 | Distal gastrectomy | 26 months | | Enterocutaneous fistula (ECF) | 1 | Repair of ECF | 8 months | Afferent limb perforation with
intraabdominal collection | 1 | Abscess drainage, external drainage of afferent limb perforation, lavage and FJ | 21 months |
| | Group 2 | | | | | Peritoneal dissemination with SAIO | 4 | Peritoneal nodule biopsy: 2
Jejunojejunal by pass: 2 | 5–19 months | | Liver metastasis | | | | | (i) Metastatic GIST-2 |
3 | Nonanatomical resection: 1
Right hepatectomy: 1 | 12/30 months | | (ii) Ruptured liver metastasis-1 | Lavage and drainage: 1 | 9 months | | Scar site recurrence | 1 | Wide local excision with mesh repair | 16 months |
| | Group 3 | | | | Radiation enteritis, jejunal stricture
with SAIO | 1 | Jejuno-jejunal by pass | 9 months | | Colonic and afferent loop necrosis | 1 | Excision of afferent loop, right hemicolectomy, revision roux-en-Y hepaticojejunostomy | 21 months | | DJ stricture | 1 | Gastrojejunostomy | 128 months |
| | Group 4 | | | | | Vascular ectasia of jejunum with upper gastrointestinal bleed | 1 | Partial gastrectomy, revision gastrojejunostomy, side to side jejunojejunostomy | 40 months |
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SAIO: sub-acute intestinal obstruction; GIST: gastrointestinal stromal tumour; PJ: pancreatico-jejunostomy; PG: pancreatico-gastrostomy; HJ: hepatico-jejunostomy; DJ: duodeno-jejunostomy; FJ: feeding jejunostomy.
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