Neoplasms

Digestive System Diseases

Gland and Hormone Related Diseases

All Conditions

Symptoms and General Pathology

Rare Diseases

Pancreatic Neoplasms

Fistula

Anastomotic Leak

Pancreatic Fistula

Gastrointestinal Diseases

Pancreatic Diseases

Pathological Conditions, Anatomical

Digestive System Fistula

Postoperative Complications

Pancreatic Cancer

All Drugs and Chemicals

Other Dietary Supplements

Glycerol

Pyruvate

All patients undergoing pancreaticoduodenectomy receive a microdialysis catheter before skin closure and will be monitored postoperatively for lactate, pyruvate, glucose and glycerol in the microdialysate at certain timepoints

A thin microdialysis catheter is implanted before skin closure after pancreaticoduodenectomy. Analyses of the microdialysate are done at certain timepoints postoperatively. No intervention is done based on the results. The patients are following standard of care.

Pancreaticoduodenectomy microdialysis catheter analyses

Espen Lindholm, ph.d

Anastomotic leakage of the pancreatojejunostomy is often discovered with considerable delay, causing severe peritonitis, hemorrhage due to erosion of vessels, sepsis, and death. Microdialysis catheters can detect focal inflammation and ischemia, and has a potential for early detection of anastomotic leakage. This observational study will examine if monitoring with microdialysis catheters can detect anastomotic leakage after pancreaticoduodenectomy earlier than current standard of care.

Pancreaticoduodenectomy (Whipple´s procedure) offers the only potential cure for patients with tumor in the head of the pancreas, bile duct or periampullary region. This procedure is associated with high perioperative and postoperative mortality and morbidity. Postoperative pancreatic fistulae (POPF) is the most feared complication, and is often discovered with significant delay resulting in development of organ dysfunction and sepsis. Current standard for clinical detection of POPF is limited and nonspecific.

Microdialysis catheters allow bedside measurements of metabolism such as lactate, pyruvate, glucose and glycerol. The method has a high sensitivity and specificity in detecting complications in several types of abdominal surgery. However, microdialysis used after pancreaticoduodenectomy is not well documented. This observational study examine if monitoring with microdialysis catheters can detect anastomotic leakage after pancreaticoduodenectomy earlier than current standard of care.

Early Detection of Anastomotic Leakage by Microdialysis Catheters

Early Detection of Anastomotic Leakage by Microdialysis Catheters: An Observational Study on Pancreaticoduodenectomy

Glycerol concentration of the microdialysate is measured hourly during the first 24 hours and thereafter every 2-4 hours during hospitalization at an average of 10 days after surgery

Glucose concentration of the microdialysate is measured hourly during the first 24 hours and thereafter every 2-4 hours during hospitalization at an average of 10 days after surgery

Lactate concentration of the microdialysate is measured hourly during the first 24 hours and thereafter every 2-4 hours during hospitalization at an average of 10 days after surgery

Pyruvate concentration of the microdialysate is measured hourly during the first 24 hours and thereafter every 2-4 hours during hospitalization at an average of 10 days after surgery

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Early Detection of Anastomotic Leakage by Microdialysis Catheters	NCT03627559	Pancreatic Canc... Pancreaticoduod... Pancreas; Fistu... Pancreatic Fist...	Pancreaticoduod...	18 Years -	Oslo University Hospital
Early Detection of Anastomotic Leakage by Microdialysis Catheters	NCT03627559	Pancreatic Canc... Pancreaticoduod... Pancreas; Fistu... Pancreatic Fist...	Pancreaticoduod...	18 Years -	Oslo University Hospital

Spots Global Cancer Trial Database for pancreaticoduodenal; fistula