Immediate Postoperative Care for Patients with Total Pancreatectomy

概要

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This report was on the bais of experience with 22 cases of total pancreatectomy during the last 27 years. The postoperative care for them was reviewed. The postoperative period is divided into two periods: the surgical period and the medical period. The surgical period means 30 to 50 days after surgery when intravenous infusion of the nutrition and water is required. The medical period is the duration following to the surgical period when the patient is cared for at the medical ward or as an outpatient.The surgical period comprises an immediate period when oral water intake is immposible or not sufficiently feasible, and an intermediate period during which additional intravenous energy supply might be required. During the immediate period, the continous intravenous infusion of the solution of 200gm of glucose and 40 units of regular insulin for 24 hours was the most successful care. At the intermediate period, without restriction of food intake and with intravenous energy supply, if required, at least 20 units of regular insulin per day should be administered subcutanously.About 20gm of pancreatin given before, during and after each meal successfully improved the disturbed digestive function.
財団法人日本消化器病学会の論文