Treatment of complications after pancreatic cancer surgery

Currently, the most effective treatment for pancreatic cancer is surgery, but due to the special nature of pancreatic cancer, there will be some special complications, such as postoperative bleeding, pancreatic fistula, gastroparesis, etc. What are the complications after pancreatic cancer surgery? Today we will introduce the treatment methods for complications of pancreatic cancer surgery.

Complications after pancreatic cancer surgery: postoperative bleeding

Postoperative bleeding within 24 hours after surgery is acute bleeding, and more than 24 hours is delayed bleeding. It mainly includes abdominal bleeding and gastrointestinal bleeding.

Complications after pancreatic cancer surgery: abdominal hemorrhage

This is mainly due to incomplete hemostasis during surgery, the illusion of hemostasis at the bleeding point under hypotension during surgery, or the detachment of the ligature, the detachment of the electrocoagulation scab, insufficient examination before closing the abdomen, and coagulation mechanism disorders are also one of the causes of bleeding. The main prevention and treatment methods are strict hemostasis during surgery, careful examination before closing the abdomen, suture of important blood vessels, and correction of coagulation function before surgery. When abdominal bleeding occurs, it should be taken very seriously. If the amount is small, hemostasis can be performed, blood transfusion can be performed, and observation can be performed. If the amount is large, surgery should be performed to stop bleeding as soon as possible while correcting microcirculation disorders.

Complications after pancreatic cancer surgery: gastrointestinal bleeding

Stress ulcer bleeding usually occurs more than 3 days after surgery. Its prevention and treatment mainly focus on correcting the patient's nutritional status before surgery, and minimizing the impact of surgery and anesthesia. The treatment is mainly conservative, using hemostatic drugs, acid suppression, gastrointestinal decompression, gastric lavage with iced renal saline injected through a gastric tube, and hemostasis through gastroscopy and angiography embolization. Those who are ineffective with conservative treatment can undergo surgery.

Complications after pancreatic cancer surgery: pancreatic fistula

If amylase-containing fluid is still drained 7 days after surgery, pancreatic fistula should be considered. The Johns Hopkins standard is that the pancreatic enzyme content in the peritoneal drainage fluid is greater than 3 times the serum value and the daily drainage is greater than 50 ml. The treatment of pancreatic fistula is mainly adequate drainage and nutritional support.

Complications after pancreatic cancer surgery: gastroparesis

There is no unified standard for gastroparesis. The commonly used diagnostic criteria are: examination confirms that there is no obstruction in the gastric outflow tract; gastric juice >800ml/d for more than 10 days; no obvious abnormalities in water, electrolyte and acid-base balance; no underlying disease causing gastric atony; and no use of smooth muscle contraction drugs.

The treatment of gastroparesis is mainly to fully decompress the gastrointestinal tract, strengthen nutritional psychotherapy or psychological suggestion therapy; apply gastrointestinal motility drugs; treat underlying diseases and nutritional metabolism disorders; try gastroscopy, repeatedly and quickly inflate and discharge gas into the stomach, and repeat the treatment every 2-3 days.

Once pancreatic cancer has postoperative complications, they should be actively treated to prevent serious conditions. Only by properly treating postoperative complications can the success of pancreatic cancer surgery be proven, the pain of the patient can be alleviated, and the patient's life can be prolonged.