Long-term assessments after pancreaticoduodenectomy with pancreatic duct invagination anastomosis.
OBJECTIVE
The purpose of this cohort was to evaluate the long-term patency of the anastomosis and the remnant pancreatic functions.


METHODS
Fifty-six consecutive patients undergoing a pancreaticoduodenectomy with pancreatic duct invagination anastomosis were enrolled in this study. During the follow-up, changes in the remnant pancreatic duct size, pancreatic exocrine and endocrine functions, and nutritional status were monitored.


RESULTS
No seriously activated pancreatic fistula, no hemorrhagic complications, no reoperations, and no in-hospital deaths were observed after surgery. A dilatation of remnant pancreatic duct was detected a total of 37 times (51%) during annual computed tomography (CT) evaluations. Pancreatic dysfunctions were observed in a considerable number of patients (exocrine 4/12, 9/14, and 8/16, endocrine 9/35, 8/27, and 4/16 at 1, 2, and 3 postoperative years, respectively). Functional declines in the remnant pancreas, duct dilatation, and a decrease in the body mass index were observed from the first year. However, these data did not progressively deteriorate thereafter, at least during the first 3 postoperative years. This study demonstrated a significant correlation between the duct dilatation and endocrine dysfunction.


CONCLUSIONS
Our pancreatic duct invagination anastomosis resulted in somewhat limited long-term outcomes, although it did prevent serious complications in the short-term.
Fujino
Yasuhiro
Y
Department of Gastroenterological Surgery, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Suzuki
Yasuyuki
Y
Matsumoto
Ippei
I
Sakai
Tetsuya
T
Ajiki
Tetsuo
T
Ueda
Takashi
T
Kuroda
Yoshikazu
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010183:Pancreatic Ducts / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome