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J Laparoendosc Adv Surg Tech A. 2013 Jul;23(7):617-20. doi: 10.1089/lap.2012.0321.

A new technique of mesh-reinforced pancreaticogastrostomy: report of 13 initial cases.

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  • 1Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Abstract

BACKGROUND:

Pancreatic anastomotic leakage is a common problem after pancreaticoduodenectomy and is a leading cause of postoperative morbidity and mortality. It is important to establish a safe and simple technique of pancreatic-enteric anastomosis to minimize pancreatic leakage.

PATIENTS AND METHODS:

From July 2009 to February 2012, a new method of mesh-reinforced pancreaticogastrostomy was performed in 13 patients after completion of the pancreaticoduodenal resection. Patient demographic data, pathology of lesions, operative parameters, and postoperative outcomes were analyzed.

RESULTS:

The mean operative time was 6.9 hours (range, 5-11 hours), and the mean time for pancreaticogastrostomy was 25 minutes (range, 22-35 minutes). Intraoperative tests showed all pancreatic anastomoses were watertight. There was no postoperative death. No patient developed clinically significant pancreatic leakage (grade B or C) after operation; 1 patient (7.7%) was recognized to have a grade A pancreatic leakage. No significant complication (hemorrhage, intra-abdominal abscess, or cholangitis) was observed. The mean postoperative hospital stay was 20 days (range, 11-30 days). After discharge, all patients recovered well in the 4-week follow-up period without emergency room visit or re-admission.

CONCLUSIONS:

The mesh-reinforced pancreaticogastrostomy provides a new way to perform pancreatic-enteric drainage after pancreaticoduodenectomy and has the advantages of simplicity, ease of handling, and applicability to all types of pancreatic remnants.

[PubMed - indexed for MEDLINE]
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