Pancreatic stump-closed pancreaticojejunostomy can be performed safely in normal soft pancreas cases

J Surg Res. 2012 Jan;172(1):e11-7. doi: 10.1016/j.jss.2011.09.002. Epub 2011 Oct 1.

Abstract

Background: Pancreatic anastomotic failure remains the main reason for morbidity and mortality after pancreaticoduodenectomy, and there is no existing flawless pancreaticojejunal reconstruction approach to this date, especially for the normal soft pancreas cases.

Methods: We compared a pancreatic stump-closed pancreaticojejunostomy technique (group B; n = 33) with conventional duct-to-mucosa fashion (group A; n = 30) retrospectively in 63 normal soft pancreatic texture cases. Some operative related data including postoperative complications, anastomosis time, hospital stay days, mortality rate, and relaparotomy rate were analyzed.

Results: There was no difference concerning the incidences of postoperative morbidity, including pancreatic fistula, postpancreatectomy hemorrhage, delayed gastric emptying, intra-abdominal abscess, and remnant pancreatitis between two groups. The differences of anastomosis time, hospitalization days, relaparotomy rate, and mortality rate were also not significant. However, group B patients had a shorter duration (d) for healing of postoperative pancreatic fistula than group A (15.3 ± 8.5 versus 33.0 ± 14.1 d, P < 0.05).

Conclusion: For the normal soft pancreas cases, pancreatic stump-closed pancreaticojejunostomy technique is quite safe and convenient according to our experience; ideal clinical results could be achieved with its application in the future.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bile Duct Neoplasms / surgery
  • Cholangiocarcinoma / surgery
  • Female
  • Humans
  • Incidence
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreas / surgery*
  • Pancreatic Neoplasms / surgery
  • Pancreaticojejunostomy / adverse effects*
  • Pancreaticojejunostomy / methods*
  • Pancreaticojejunostomy / mortality
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Survival Rate