title: Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: results of a prospective randomized trial.
abstract: BACKGROUND
  Anastomotic failure is still a significant problem that affects the outcome of pancreaticoduodenectomy. There have been many techniques proposed for the reconstruction of pancreatic digestive continuity, but there have been few prospective and randomized studies that compare their efficacy.
  
  
  METHODS
  In the current work, 144 patients who underwent a pancreaticoduodenectomy with soft residual tissue were assigned randomly to receive either a duct-to-mucosa anastomosis (group A) or a 1-layer end-to-side pancreaticojejunostomy (group B).
  
  
  RESULTS
  The 2 treatment groups were found not to have any differences in regards to vital statistics, underlying disease, or operative techniques. The postoperative course was complicated in 54% of the 144 patients, with a comprehensive incidence of abdominal complications in 36% (group A, 35%; group B, 38%; P=not significant). The principal complication was pancreatic fistulas, which occurred in 14% of patients (group A, 13%; group B, 15%; P=not significant). Two patients (2%) required reoperation; the postoperative mortality rate was 1%.
  
  
  CONCLUSIONS
  The 2 methods that were studied revealed no significant difference the rate of complications.
authors.affiliation: Surgical and Gastroenterological Department, Endocrine and Pancreatic Unit, Hospital G.B. Rossi University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Massimo
authors.initials: M
authors.lastname: Falconi
authors.forename: Enrico
authors.initials: E
authors.lastname: Molinari
authors.forename: William
authors.initials: W
authors.lastname: Mantovani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Butturini
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Gumbs
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvia
authors.forename: Paolo
authors.initials: P
authors.lastname: Pederzoli
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010193:Pancreaticojejunostomy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies