Comparative study of anastomosis in pancreaticogastrostomy and pancreaticojejunostomy after pancreaticoduodenectomy.
OBJECTIVE
The relative advantages of pancreaticojejunostomy and pancreaticogastrostomy after pancreaticoduodenectomy remain to be established. To clarify differences between the two procedures, we examined 66 patients who underwent PD and compared clinical and histological parameters, surgical records and patient outcomes.


METHODS
In this retrospective study, subjects were divided into a pancreaticojejunostomy group (n=48) and a pancreaticogastrostomy group (n=18). Pancreaticogastrostomy and pancreaticojejunostomy were performed using invagination technique and end-to-side anastomosis, respectively.


RESULTS
There were no significant differences in patient demographics and surgical records between the two groups. Increases in serum amylase concentrations after operation were significantly greater in the pancreaticogastrostomy group (902 +/- 915 IU/L) than in the pancreaticojejunostomy group (326 +/- 761 IU/L) (p = 0.025). However, there were no significant differences in other postoperative laboratory data or complications between the two groups.


CONCLUSIONS
In our study, the clinical and safety data associated with pancreaticojejunostomy and pancreaticogastrostomy procedures for anastomosis after pancreaticoduodenectomy were almost similar. Therefore, the anastomotic procedure used should depend on the surgeon's choice or the distance between the remnant stomach and pancreas.
Nanashima
Atsushi
A
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Sumida
Yorihisa
Y
Abo
Takafumi
T
Shindo
Hisakazu
H
Fukuoka
Hidetoshi
H
Tanaka
Kenji
K
Takeshita
Hiroaki
H
Hidaka
Shigekazu
S
Sawai
Terumitsu
T
Yasutake
Toru
T
Nagayasu
Takeshi
T
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D004066:Digestive System Diseases / Q000601:surgery*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D016896:Treatment Outcome