[Reconstruction following proximal pancreatoduodenectomy by simplified pancreatojejunal anastomosis. Operation results in 198 patients].
BACKGROUND
The pancreatojejunal anastomosis is considered the weak spot when carrying out a duodenopancreatectomy, because it causes most of the complications following a Whipple surgery. Here we present a series of cases using a single technique for performing this anastomosis.


METHODS
During the period between October 2002 and August 2005, 49 duodenopancreatectomies were performed at the 3AII Department of the National Hospital Edgardo Rebagliati Martins (H.N.E.R.M.) in 31 of these cases a lateral mucosa to mucosa pancreatojejunal anastomosis was carried out by the same surgeon.


RESULTS
The most frequent complication was infection of the operating wound followed by pancreatic fistula and intra-abdominal hemorrhage and the overall morbidity was 29%. Pancreatic fistula developed in 13% of the cases; however, no patient required additional treatment and the fistula closed maximum twenty days after the surgery. On average, patients resumed oral food intake after 6 days and remained hospitalized for 16 days. Mortality was 3%, because a patient developed a pseudo-aneurysm of the hepatic artery, which ruptured 17 days after the operation.


CONCLUSIONS
The mucosa to mucosa pancreatojejunal anastomosis is a safe technique with a low index of pancreatic fistula and mortality.
Celis Zapata
Juan
J
Departamento del Abdomen, INEN, Lima, Peru.
Berrospi Espinoza
Francisco
F
Ruíz Figueroa
Eloy
E
Payet Meza
Eduardo
E
Chávez Passiuri
Iván
I
Young Tabusso
Frank
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D004067:Digestive System Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome