Technical considerations and results of a "new" method of reconstruction of alimentary continuity after duodenopancreatectomy.
A total of (152) patients who consecutively underwent extended pancreaticoduodenectomy between 1983 and August 1992 had reconstruction of alimentary continuity, using two independent jejunal loops. One for the fashioning of a pancreatic and biliary anastomosis and the other for creating the gastric anastomosis. From the results of this study it has been shown that the present technique is contributing to low mortality, early morbidity and a satisfactory quality of post-operative life in long-term survivors. Four patients died during the first 30 days after surgery, and only 25% of those with confirmed pancreaticojejunal anastomotic leakages required early reoperation. Moreover, no patient developed marginal ulceration, or reflux gastritis, or dumping, while the incidence of steatorrhea and diabetes mellitus remained low. Additionally, the present technique makes locoregional radical surgery possible and we thus believe that it merits consideration with respect to the choice of method of reconstruction of alimentary continuity after extended pancreaticoduodenectomy. The present technique has been proved to be safe, simple and effective in fulfilling current demands on resectional pancreatic surgery, particularly in the case of pancreatic malignancies, and can therefore be recommended.
Lygidakis
N J
NJ
Department of Hepato-Biliary Pancreatic Surgery, Hellenic Cancer Institute, Saint Savas Hospital, Athens, Greece.
Savanis
G
G
Touloupakis
T
T
Pavlis
T
T
Pothoulakis
I
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods; D010193:Pancreaticojejunostomy / Q000379:methods*; D016896:Treatment Outcome