View Full Chapter Figures Only Tables Only Videos Only Print Share Email Send Email Your Name (required) ! Example: John Doe Email Address (required) ! Please enter a valid sender email address. Example: firstname.lastname@example.org CC Me Recipient Email Address (required) ! Separate multiple email address with semi-colons (up to 5). Subject Subject for your email. Message (Maximum characters: 1,000) Please enter your name Please enter your email address Please enter a valid recipient email address. Example:email@example.com Submit Cancel Thank you! Your email has been sent to: The recipient(s) will receive an email message that includes a link to the selected article. Recipients may need to check their spam filters or confirm that the address is safe. Return to: Send Another Email An error has occurred sending your email(s). Please try again later or contact an administrator at OnlineCustomer_Service@mheducation.com. Return to: Twitter Facebook Linkedin Reddit Get Citation Citation AMA Citation Osborne NH, Colletti LM. Osborne N.H., Colletti L.M. Osborne, Nicholas H., and Lisa M. Colletti.Chapter 15. Pancreaticoduodenectomy. In: Minter RM, Doherty GM. Minter R.M., Doherty G.M. Eds. Rebecca M. Minter, and Gerard M. Doherty.eds. CURRENT Procedures: Surgery New York, NY: McGraw-Hill; 2010. http://accessanesthesiology.mhmedical.com/content.aspx?bookid=419§ionid=41482829. Accessed June 27, 2017. MLA Citation Osborne NH, Colletti LM. Osborne N.H., Colletti L.M. Osborne, Nicholas H., and Lisa M. Colletti.. "Chapter 15. Pancreaticoduodenectomy." CURRENT Procedures: Surgery Minter RM, Doherty GM. Minter R.M., Doherty G.M. Eds. Rebecca M. Minter, and Gerard M. Doherty. New York, NY: McGraw-Hill, 2010, http://accessanesthesiology.mhmedical.com/content.aspx?bookid=419§ionid=41482829. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager © Copyright Tools Search Book Top Return Clip Chapter 15. Pancreaticoduodenectomy Nicholas H. Osborne, MD; Lisa M. Colletti, MD + Indications Print Section ++ Malignant lesions involving the head of pancreas, ampulla of Vater, distal end of the common bile duct, or duodenum. Absence of metastasis.Absence of arterial involvement.Refractory severe pain from chronic pancreatitis. Refractory to medical therapy.Repeat hospital admissions.Majority of disease limited to the head of the pancreas. + Contraindications Print Section ++ Absolute ++ Evidence of metastatic disease.Evidence of para-aortic nodes outside the field of dissection.Involvement of the aorta or vena cava.Involvement of the superior mesenteric artery, hepatic artery, or celiac axis. ++ Relative ++ Cardiopulmonary comorbidities. + Patient Positioning Print Section ++ The patient should be supine.The entire abdomen is shaved and prepped.The abdomen is entered through a midline incision or bilateral subcostal "Chevron" incision, depending on surgeon preference. + Postoperative Care Print Section ++ Nothing by mouth with nasogastric tube decompression.Oral diet is advanced following removal of the nasogastric tube and once ileus has resolved, usually within 48–72 hours postoperatively.Monitoring of abdominal drain fluids for evidence of a biliary or pancreatic leak. + Potential Complications Print Section ++ Delayed gastric emptying.Pancreatic leak.Surgical site infections.Gastroduodenal artery pseudoaneurysm.