Characteristics of Patients in Follow-up After the Whipple Procedure in the Intensive Care Unit: Field-specific Intensive Care Experience

Introduction:Pancreaticoduodenectomy (Whipple procedure) is an important surgical intervention in terms of adverse conditions that may occur after surgery. Our aim is to determine the change in the clinical course of the patients followed in the intensive care unit (ICU) after pancreaticoduodenectomy during the follow-up period.Methods:We included 37 patients followed up after the Whipple procedure from August 2021 to August 2022 in a tertiary ICU specific for liver-pancreas-biliary tract and liver transplantation.Results:The vital signs and laboratory values of the patients during the follow-up were examined. Statistically decreased arterial blood lactate levels and a significant increase in arterial blood partial oxygen pressures were seen upon admission to the ICU. The highest detected arterial lactate level was correlated with the percentage change in blood creatinine.Conclusion:Patients should be followed closely after the Whipple procedure. Fluid volume treatment and respiratory support play a significant role in patient recovery

How the recurrence of biliary pancreatitis can be prevented? A case report and literature review.

Diagnosis and treatment of recurrent acute pancreatitis remains a complex issue in clinical practice. Repeated episodes of pancreatitis are usually seen in a gland with a normal morphology during diagnosis, so it is believed that such a clinical entity is characterized by recurrent episodes of pancreatitis in the normal pancreas. The evaluation of patients with recurrent acute pancreatitis requires systematic identification or removal of correctable factors. In this study, we aimed to present a case of acute pancreatitis with six attacks in the light of the literature

Delayed bilhemia complicating percutaneous transhepatic biliary drainage: Successful treatment with primary coil embolization

Bilhemia is very rare and serious complication of percutaneous transhepatic biliary drainage (PBD). Bile leakage occurs into the bloodstream through a fistula between the biliary tree and the hepatic venous system. We report a case of a 45-year-old woman with bilhemia complicated by PBD. She was successfully treated with primary coil embolization of biliovenous fistula tract. In the follow-up, bilirubin values dramatically regressed and returned to its normal limits. Rapid increase in total and direct bilirubin values after PBD without biliary tree dilatation almost always suggest biliovenous fistula. It is more likely that biliovenous fistulas will develop in catheters that are removed before the time of the tract maturation. Symptomatic bilhemia should be treated as soon as possible to prevent major complications like bile pulmonary embolism and biliary sepsis. Keywords: Bilhemia, Hemobilia, Hyperbilirubinemia, Embolizatio