title: Toward zero pancreatic fistula after pancreaticoduodenectomy with pancreaticogastrostomy.
abstract: BACKGROUND
  Postoperative morbidity after pancreaticoduodenectomy has been associated mainly with the development of pancreatic fistula. However, postoperative complications unrelated to pancreatic fistula cannot be disregarded after pancreaticoduodenectomy. The aim of the present study was to investigate the postoperative morbidity in a large series of pancreaticoduodenectomies with pancreaticogastrostomies without pancreatic fistula.
  
  
  METHODS
  The present study analyzed the data from 194 consecutive patients undergoing a pancreaticoduodenectomy with a pancreaticogastrostomy between July 1997 and June 2003 in whom no postoperative pancreatic fistula occurred.
  
  
  RESULTS
  The overall rate of postoperative morbidity was 33.5%. Specific and general complications occurred in 16% and 17.5% of the patients, respectively. An American Society of Anesthesiologists (ASA) score of 3 and blood transfusion were the only independent factors associated with postoperative morbidity.
  
  
  CONCLUSIONS
  Our study found that the overall morbidity after a pancreaticoduodenectomy with a pancreaticogastrostomy still remains high even in the absence of pancreatic fistula and is associated with the preoperative medical condition (ASA score) of the patients and with blood transfusion.
authors.affiliation: Centre de Chirurgie Viscérale et de Transplantation, Hautepierre Hospital, Hôpitaux Universitaires de Strasbourg, Louis-Pasteur University, Avenue Moliere, 67200, Strasbourg, France.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Radu
authors.initials: R
authors.lastname: Scurtu
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meyer
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakano
authors.forename: Guillermo
authors.initials: G
authors.lastname: Verasay
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaeck
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D005763:Gastroenterostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D010185:Pancreatic Fistula / Q000453:epidemiology* / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome