Comparison of pancreatogastrostomy and pancreatojejunostomy after pancreatoduodenectomy performed by one surgeon.
Pancreatogastrostomy (PG) for restoring pancreaticoenteric continuity after pancreatoduodenectomy (PD) has been recommended by a few surgeons on the basis of certain theoretic and practical advantages of this procedure over pancreatojejunostomy (PJ). The purpose of this study was to determine whether PG can be a safe alternative to PJ. Eighty-six PDs performed by the same surgeon for periampullary carcinoma were analysed to compare early and late postoperative results of PJ (n = 38) and PG (n = 48). The two groups were comparable for age, sex, diagnosis, stage, and operation time. PJ leakage developed in six patients (15.8%) and PG leakage in one (2.1%) (p < 0.05). Overall rates of morbidity/hospital mortality were 34.2/7.9% and 18.8/4.2% in the PJ and PG groups, respectively. In conclusion, PG showed a more favorable early outcome than PJ. PG is recommended for surgeons who encounter difficulties with PJ for reconstruction after PD.
Kim
S W
SW
Department of Surgery, Seoul National University College of Medicine, Korea.
Youk
E G
EG
Park
Y H
YH
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D004379:Duodenal Neoplasms / Q000601:surgery; D005260:Female; D005774:Gastrostomy; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D011183:Postoperative Complications; D012189:Retrospective Studies