Pr Pham Nhu Hiep
Duodenopancreatectomy (DPC) is a program operation and it has complex, difficult, postoperative complications. Usually, this technich was realised for tumors of pancreas or ampullo-vaterian, we have peformed it since 1999. Sometimes, in abdominal emergency, we have to use this operation in case of irreversible severe duodeno-pancreatic trauma.
On 12/12/2007, a 27-year-old man was hospitalised at Hue Central Hospital which severed abdominal injury, hypovolemia shock, hematemese, red blood cells falled from 4.300.000 to 2.300.000 after 15minutes of admission. Sonography showed an important hemoperitonum, gas intrabdomen,... The patient was operated imediately.
After using duodenopancreatectomy procedure
After a midle large incision was perfomed, we saw a big haemorrhage with 2,5 litres of blood, duodenum complete rupture and ischemia, big volume of blood intragastric (1 litre of blood), important head pancreas traumatism, rupture CBD,... (5th degee).
We had to realise duodenopancreatectomy technic for saving the patient. This procedure was perfomed with pyloric conservation technic, 3 anastomoses were realised then, at the same time, we transfusioned blood (3 litres) and other fluids, operation time was 4 hours.
Patient was back to normal after 7 days, without any complication. It was the firts emergency duodenopancreatectomy at Hue Central Hospital.