The clinical results of duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy in consecutive 55 cases.
OBJECTIVE
Pancreatic anastomotic leakage remains a major troublesome complication after pancreaticoduodenectomy. Thus, various technical modifications regarding the pancreatic anastomosis after pancreaticoduodenectomy have been attempted to minimize anastomotic leakage. We have performed duct-to-mucosa pancreaticojejunostomy with resection of jejunal serosa (layer-to-layer pancreaticojejunostomy) and obtained extremely favorable results.


METHODS
During 1999 to 2006, 55 patients (27 women and 28 men) underwent duct-to-mucosa pancreaticojejunostomy with resection of jejunal serosa after pancreaticoduodenectomy. The mean age was 64.6 years (range, 33-84 years).


RESULTS
Median postoperative hospital stay was 32.8 days. Morbidity rate due to early postoperative complication was 9.1% (pneumothorax in 1, pulmonary embolism in 1, gastric ulcer in 1, and wound infection in 2), with no pancreatic anastomotic leakage.


CONCLUSIONS
There was low complication rate and no pancreatic anastomotic leakage in consecutive 55 patients who underwent pancreaticoduodenectomy. We consider that duct-to-mucosa pancreaticojejunostomy with resection of jejunal serosa is extremely safe, reliable, and favorable for the anastomosis after pancreaticoduodenectomy.
Hayashibe
Akira
A
Department of Surgery, Bell Land General Hospital, Osaka, Japan. akirah1@hotmail.com
Kameyama
Masao
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000706:statistics & numerical data*; D010193:Pancreaticojejunostomy / Q000379:methods / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome