Reappraisal of pancreaticojejunostomy after pancreaticoduodenectomy: a report of 86 cases with particular reference to the rate of pancreatic fistulation.
OBJECTIVE
To report our experience of 86 patients who underwent pancreaticoduodenectomy followed by pancreaticojejunostomy, paying particular attention to the rate of fistulation.


METHODS
Retrospective study.


METHODS
Two teaching hospitals, France.


METHODS
86 patients (58 men and 28 women) who required pancreatic resection for adenocarcinomas of the head of the pancreas (n = 34), chronic pancreatitis (n = 21), cancer of the ampulla of Vater (n = 12), cancer of the distal bile duct (n = 6), or other causes (n = 13).


METHODS
Pancreaticoduodenectomy followed by pancreaticojejunostomy with mucosa to mucosa suture.


RESULTS
26 patients (30%) developed complications, 9 (10%) required reoperation, and 8 (9%) died postoperatively. Pancreatic fistulas developed in 2 (2%), one of whom was successfully treated conservatively. The other was reoperated on and died on day 40.


CONCLUSIONS
Pancreaticojejunostomy after pancreaticoduodenectomy is safe, and the rate of fistulation compares favourably with that after pancreaticogastrostomy (2%).
Berdah
S
S
Department of Surgery, Hôpital Ste Marguerite, Marseilles, France.
Panis
Y
Y
Gleizes
V
V
Sastre
B
B
Valleur
P
P
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D001650:Bile Duct Neoplasms / Q000601:surgery; D002908:Chronic Disease; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D010195:Pancreatitis / Q000601:surgery; D011183:Postoperative Complications