Experience with end-to-loop pancreaticoenteroanastomosis in pancreaticoduodenectomy.
OBJECTIVE
Early results of 151 pancreaticoduodenectomies were retrospectively studied.


METHODS
Pancreaticoduodenectomy was performed in 129 (85.5%) patients with periampullary carcinoma, in 18 (11.9%) with chronic pancreatitis and in 4 (2.7%) patients with other pathologies. Pancreaticoenteroanastomosis was placed in 125 (82.8%) patients, end-to-loop virsungoenteroanastomosis according to V. Onopriev and A. Manuilov was applied in 79 (52.3%) patients (group I). A routine end-to-side anastomosis (group II) was used in 46 (30.5%) cases; other techniques of the pancreatic stump management were performed in 26 patients.


RESULTS
The lethality rate was 11.3%. It varied depending on the type of pancreaticoduodenectomy completion. Three patients with the end-to-loop virsungoenteroanastomosis died in the early postoperative period, compared with 7 (15.2%) deaths in the group with the end-to-side anastomosis. The incidence of postoperative complications was 32.9% in group I, 52.2% in group II. In group I there were no cases of failure of pancreatoenteroanastomosis, in group II this complication was present in 2 (4.4%) patients. Leakage of the pancreatic secretions into the abdominal cavity was revealed in 4 (5.1%) patients of group I, and in 10 (21.7%) of group II.


CONCLUSIONS
The technique of the end-to-loop virsungoenteroanastomosis allows the improvement of early results of pancreaticoduodenectomy due to reduction in infectious and inflammatory complications.
Department of Pancreatic Surgery, All-Russian Center for Surgical Gastroenterology, Krasnodar, Russia. onopr@mail.ru
Vladimir
V
Onopriev
Alexander
A
Manuilov
Mikhail
M
Rogal
Sergei
S
Voskanyan
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010195:Pancreatitis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome