A comparison of the complication rate for three pancreaticojejunostomy techniques.
OBJECTIVE
A variety of techniques for pancreaticojejunostomy have been employed with introduction of safer anastomosing methods in our department as an extended excision of the pancreas was performed. In this study, complications associated with the various techniques of pancreaticojejunostomy were investigated in order to find a safer anastomosing method.


METHODS
The extent of excision and complication rate of three types of pancreaticojejunostomy (impaction method, subserosal anastomosis and non-division procedure) were investigated in 64 patients who underwent pancreatoduodenectomy for diseases of the pancreas and biliary system. The end-to-side anastomosis of the pancreas and jejunum without division of the jejunoserosal tunica muscularis (non-division method) is an anastomotic method with a low risk of suture insufficiency.


RESULTS
The incidence of secondary complications in the patients with suture insufficiency was higher than that in the patients with leakage of pancreatic juice. Once leakage of pancreatic juice and suture insufficiency occurred, the incidence of secondary complications was high after extended excision.


CONCLUSIONS
From these results, the non-division method was found to be a safe anastomosing method. After an extended excision is performed, intraperitoneal drainage is necessary.
Nagakawa
T
T
2nd Department of Surgery (Department of Health Sciences), School of Medicine, Kanazawa University, Japan.
Konishi
I
I
Ueno
K
K
Ohta
T
T
Kayahara
M
M
Miyazaki
I
I
D001650:Bile Duct Neoplasms / Q000601:surgery; D004322:Drainage; D006801:Humans; D015994:Incidence; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D013536:Suture Techniques