Modified technique of pancreaticojejunal anastomosis with invagination following pancreaticoduodenectomy: a cohort study.
BACKGROUND
Leakage from pancreatic anastomoses remains the single most important morbidity after pancreaticoduodenectomy and contributes to prolonged hospitalization and mortality. This observational cohort study reported the surgical outcome of a modified invagination technique of pancreaticojejunostomy after pancreaticoduodenectomy.


METHODS
Between December 2001 and December 2007, a total of 52 consecutive patients underwent elective pancreaticoduodenectomy for benign or malignant pathologies of the pancreas or the periampullary region in a tertiary referral center. All patients underwent our modified invagination technique of pancreaticojejunostomy regardless of the characteristics of the pancreatic stump. Data were collected prospectively.


RESULTS
The mean hospital stay was 12.6 +/- 3.2 days. The incidence of overall surgical complications was 9.6%. No patient developed pancreatic fistula. One patient (1.9%) died of respiratory failure on postoperative day 7.


CONCLUSIONS
We reported our pancreaticojejunostomy anastomosis technique with a pancreatic fistula rate of 0% and low intra-abdominal complication rate. The favorable results of this technique warrant further investigation in large prospective cohort studies and prospective randomized controlled studies.
Chen
Huan-Wei
HW
Department of Hepatobiliary Surgery, The First People's Hospital of Foshan, Foshan, 528000, Guang Dong, The People's Republic of China.
Lai
Eric C H
EC
Su
Shu-Ying
SY
Cai
Yun-Feng
YF
Zhen
Zuo-Jun
ZJ
Lau
Wan Yee
WY
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D013536:Suture Techniques; D016896:Treatment Outcome