Is pancreaticogastrostomy safer than pancreaticojejunostomy?
OBJECTIVE
Failure of a pancreatic-enteric anastomosis very frequently leads to morbidity and mortality after pancreaticoduodenectomy. Pancreaticojejunostomy or pancreaticogastrostomy is often used after pancreaticoduodenectomy. The many reports on pancreaticogastrostomy support the low rates of anastomotic leakage and mortality compared with pancreaticojejunostomy.


METHODS
Between January 1995 and December 2004, 155 pancreaticojejunostomies and 58 pancreaticogastrostomies were performed after pancreatic resection in the Second Department of Surgery of Nagoya University Hospital. Postoperative morbidity and mortality were analyzed.


RESULTS
The incidence of pancreatic fistula was similar for the pancreaticojejunostomy (12.2%) and pancreaticogastrostomy (20.7%) groups and the mortality rate was 0% in both groups.


CONCLUSIONS
This restrospective clinical study suggested no significant difference in the incidence rate of pancreatic fistula and mortality between pancreaticojejunostomy and pancreaticogastrostomy.
Nakao
Akimasa
A
Second Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Fujii
Tsutomu
T
Sugimoto
Hiroyuki
H
Kaneko
Tetsuya
T
Takeda
Shin
S
Inoue
Soichiro
S
Nomoto
Shuji
S
Kanazumi
Naohito
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005763:Gastroenterostomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010185:Pancreatic Fistula / Q000209:etiology; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies