Pancreaticogastrostomy: unreliable long-term pancreatic duct patency.
OBJECTIVE
Long-term patency of pancreaticogastrostomy remains unclear. The purpose of this study is to clarify the long-term patency of pancreaticogastrostomy based on change in the main pancreatic duct diameter.


METHODS
Seventeen of 33 patients who underwent pancreaticogastrostomy in our institution were divided into 2 groups according to the preoperative diameter of main pancreatic duct: the non-dilated group (phi main pancreatic duct < or = 4 mm, 11 patients) and the dilated group (phi main pancreatic duct > or = 5 mm, 6 patients). Clinical and radiological parameters were assessed by a postoperative comparison between the 2 groups.


RESULTS
phi main pancreatic duct after operation was dilated in all 11 patients in the non-dilated group, and the difference was significant (p = 0.0003, mean dilatation ratio = 2.6) when compared with phi main pancreatic duct before operation. In contrast, the mean phi main pancreatic duct decreased after operation (mean dilatation ratio = 0.9) in the dilated group. Clinical symptoms (5 patients), impaired endocrine and exocrine pancreatic function (4 and 3 patients, respectively), elevated serum amylase level (6 patients), and pancreatic parenchymal changes on radiological examinations (5 patients) were observed only in the non-dilated group.


CONCLUSIONS
Degree of dilatation of main pancreatic duct seems to correspond to likelihood of anastomotic stenosis of pancreaticogastrostomy. Pancreaticogastrostomy has less reliability in terms of the long-term patency in cases having non-dilated main pancreatic duct.
Kurosaki
Isao
I
Department of Surgery, School of Medicine, Faculty of Medicine, Niigata University, 1-757 Asahimachi-dori, Niigata City, 951 Japan.
Hatakeyama
Katsuyoshi
K
Kobayashi
Takashi
T
Nihei
Ko-ei
KE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D004108:Dilatation, Pathologic; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010183:Pancreatic Ducts / Q000473:pathology*; D013536:Suture Techniques; D016896:Treatment Outcome