The Evaluation of Duct‐to‐mucosal Pancreaticojejunostomy in pancreaticoduodenectomy

This study was conducted to examine the efficacy of duct‐to‐mucosal pancreaticojejunostomy compared with external stented pancreaticojejunostomy in prevention of several complications, retrospectively. Seventy‐six patients with pancreatic head resection (59 male; median age, 60.1 years) underwent pa...

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Bibliographic Details
Published in:World journal of surgery 2005-01, Vol.29 (1), p.76-79
Main Authors: Tani, Masaji, Onishi, Hironobu, Kinoshita, Hiroyuki, Kawai, Manabu, Ueno, Masaki, Hama, Takashi, Uchiyama, Kazuhisa, Yamaue, Hiroki
Format: Article
Language:English
Subjects:
Aged
Bile Duct Cancer
Biological and medical sciences
Female
General aspects
Humans
Intraductal Papillary Mucinous Tumor
Male
Medical sciences
Middle Aged
Pancreatic Duct
Pancreatic Fistula
Pancreatic Juice
Pancreaticoduodenectomy - adverse effects
Pancreaticojejunostomy - adverse effects
Postoperative Complications - prevention & control
Retrospective Studies
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Summary:This study was conducted to examine the efficacy of duct‐to‐mucosal pancreaticojejunostomy compared with external stented pancreaticojejunostomy in prevention of several complications, retrospectively. Seventy‐six patients with pancreatic head resection (59 male; median age, 60.1 years) underwent pancreaticoduodenectomy at the Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan, between January 1, 1994, and March 31, 2002. In early postoperative status, the incidence of pancreatic fistula by duct‐to‐mucosal anastomosis (n = 45) was similar to that by external stent (n = 31); soft pancreas is a risk factor of pancreatic fistula compared with hard pancreas (p < 0.05). During the late postoperative period, however, no patients with duct‐to‐mucosal anastomosis showed pancreatic duct dilatation by computed tomography (CT). At the same time, 58.8% of patients with external stent followed by CT showed pancreatic duct dilatation (p < 0.01). The duct‐to‐mucosal anastomosis was more effective pancreaticojejunostomy than the external stent in terms of prevention of pancreatic duct dilatation, and it should be the surgical procedure of choice in pancreaticoduodenectomy.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-004-7507-0