P-263 Poster of distinction

Heterotopic pancreas atuotransplantation with spleen for uncontrollable hemorrhagic pseudocyste

Y. Sato, H. Oya, S. Yamamoto, H. Kokai, K. Miura, K. Hatakeyama
Niigata University Graduate School of Medical and Dental Sciences, Division of Digestive and General Surgery, Niigata, Japan

In this study, we report a heterotopic pancreatic autotransplantation (HPAT) with spleen for an alcoholic chronic pancreatitis with hemorrhagic pseudocyte and complete portal venous obstruction. The patient was a 72-year-old man who had an alcoholic chronic pancreatitis with severe abdominal pain and hemorrhagic pancreatitis. The first bleeding from a pseudo aneurism of gastro-duodenal artery (GDA) to the cyste of pancreas head was stopped by interventional radiology (IVR) at our hospital on May 2010. The second bleeding was happened with severe abdominal pain on February 15^th, 2011. He administered on February 17. The IVR was done, however it was not successful. There were two problems for the operation. The one is the severe inflammation, and the other was the control of hemorrhage from GDA. We were afraid of the postoperative hemorrhage due to the leakage of pancreatic juice in the pancreato-duodenectomy (PD). Therefore, we chose the HPAT for a solution of postoperative hemorrhage and severe abdominal pain. After complete duodeno-pancreatectomy with spleen, we performed HPAT on March 8, 2011. First, the right iliac vein and splenic vein anastomoses were made using 6-0 prolene polypropylene sutures. Second, the right iliac artery to splenic arterial anastomosis was made using 7-0 polypropylene sutures. Third, the pancreatic duct recon- struction was performed using a mucosal-mucosal end-to-side Roux- en- Y anastomosis to the jejunum using 6-0 PDS sutures. Postoperative course was ueventful. The abdominal pain has resolved and the patient remains normoglycemic after HPAT. We conclude that HPAT is an useful option for hemorrhagic pseudocyte of the pancreas head with severe abdominal pain of chronic pancreatitis.

P-263 Poster of distinction

Heterotopic pancreas atuotransplantation with spleen for uncontrollable hemorrhagic pseudocyste

Y. Sato, H. Oya, S. Yamamoto, H. Kokai, K. Miura, K. Hatakeyama
Niigata University Graduate School of Medical and Dental Sciences, Division of Digestive and General Surgery, Niigata, Japan

In this study, we report a heterotopic pancreatic autotransplantation (HPAT) with spleen for an alcoholic chronic pancreatitis with hemorrhagic pseudocyte and complete portal venous obstruction. The patient was a 72-year-old man who had an alcoholic chronic pancreatitis with severe abdominal pain and hemorrhagic pancreatitis. The first bleeding from a pseudo aneurism of gastro-duodenal artery (GDA) to the cyste of pancreas head was stopped by interventional radiology (IVR) at our hospital on May 2010. The second bleeding was happened with severe abdominal pain on February 15^th, 2011. He administered on February 17. The IVR was done, however it was not successful. There were two problems for the operation. The one is the severe inflammation, and the other was the control of hemorrhage from GDA. We were afraid of the postoperative hemorrhage due to the leakage of pancreatic juice in the pancreato-duodenectomy (PD). Therefore, we chose the HPAT for a solution of postoperative hemorrhage and severe abdominal pain. After complete duodeno-pancreatectomy with spleen, we performed HPAT on March 8, 2011. First, the right iliac vein and splenic vein anastomoses were made using 6-0 prolene polypropylene sutures. Second, the right iliac artery to splenic arterial anastomosis was made using 7-0 polypropylene sutures. Third, the pancreatic duct recon- struction was performed using a mucosal-mucosal end-to-side Roux- en- Y anastomosis to the jejunum using 6-0 PDS sutures. Postoperative course was ueventful. The abdominal pain has resolved and the patient remains normoglycemic after HPAT. We conclude that HPAT is an useful option for hemorrhagic pseudocyte of the pancreas head with severe abdominal pain of chronic pancreatitis.