Background: Duct to mucosa Pancreatico-gastrostomy (DMPG) is a method for reconstruction of pancreatic mass following pancreaticoduodenectomy (PD). There are still controversies about the benefits of this surgical technique compared to the old ones. Objectives: This study aimed to evaluate the long-term outcomes of DMPG reconstruction following PD operation. Method: Through a prospective observational setting, 164 patients, undergoing PD surgery, with diagnosed pancreatic head or peri-ampullary cancer, were enrolled. A pylorus-preserving PD and DMPG were done for all patients to reconstruct the pancreatic mass. Patients were followed up to a mean of 21.06±14.12 months. Demographic data, risk factors, tumoral staging, and postoperative follow-up data were collected for the analytic study. Results: The mean survival of the patients was 21.06±14.23 months after surgery. DGE (delayed gastric emptying) (34.75%), pancreatic fistula (21.34%), bile duct fistula (7.31%), and hemorrhage (5.5%) were recorded as the most important complication in patients. Some post-operative complications were significantly observed in patients with diabetes mellitus (pancreatic fistula, increased amylase, and DGE), Smokers (bile duct fistula, hemorrhage, and increased Amylase), and the elders (bile duct fistula) (p-value <0.05). Conclusions: Although our results indicate that DMPG reconstruction is a safe technique, our findings did not confirm the priority of this method over the older techniques.
Introduction: Investigating and recognizing the epidemiological structure of earthquake damages in earthquake- prone countries is of great importance. The aim of this study was to evaluation of traumatic injuries in1028 patients referred to the Ayatollah Taleghani Hospital from the Sarpul-Zahab earthquake (November 12, 2017). Method: This study is a cross-sectional study that includes 1028 traumatic patients from the Kermanshah earthquake. The patients, including outpatients in the emergency department, admitted in orthopedic, general surgery and neurosurgery, or even patients who needed to be transferred to other treatment centers. Result: Of the 1,028 patients, 488 were men (47.5%). The number of men with high injury severity was 51 (10.4%) and the number of women with high severity of the injury was 58 (10.7%). The average age of the injured was 33.04±15.01 years. The mean ISS measure in this study was 8.9±1.6. A total of 109 (10.6%) had scores above 17. The number of cases with head and neck injury was 328 (24%), 233 cases (17%), chest 114 (8.3%), The abdomen or pelvis is 190 (13.9%), the spine is 200 patients (14.6%). After examining the type of trauma in 1791 injuries, 1074 injuries (59.9%) had penetrating trauma and 717 injuries (40.1%) of blunt trauma were calculated. Of patients with severe trauma, 83 patients suffered severe injuries (7.7%) and in patients with blunt trauma, 68 patients suffered severe injuries (9.4%). The mortality rate was 5 (0.5%). Conclusion: This study established a fracture pattern in the referred patient of the Sarpul-Zahab earthquake to the Ayatollah Taleghani Hospital and is practical for clinicians to increase understanding of this natural disaster and permits superior selection of the triage management and therapeutic process.
