title: Comparison of postoperative morphological changes in remnant pancreas between pancreaticojejunostomy and pancreaticogastrostomy after pancreaticoduodenectomy.
abstract: OBJECTIVE
  The aim of this study was to compare postoperative morphological changes in remnant pancreas between pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) after pancreaticoduodenectomy (PD).
  
  
  METHODS
  The study subjects were 28 patients with PJ and 14 with PG. The diameter of the main pancreatic duct (MPD) and pancreatic parenchymal thickness 2 years after PD were measured on computed tomography scans and compared between the 2 groups.
  
  
  RESULTS
  The preoperative and postoperative MPD diameter was 5.2 mm (SD, 2.4 mm) and 4.2 mm (SD, 2.0 mm) in the PJ group (P = 0.0422) and 4.8 mm (SD, 3.2 mm) and 5.7 mm (SD, 1.8 mm) (P = 0.1494) in the PG group, respectively. In those patients with preoperatively normal-size MPD, MPD after surgery tended to become dilated relative to before surgery in the PJ group (P = 0.0931), and the MPD measured postoperatively was significantly larger than preoperatively in the PG group (P = 0.0009). A significant atrophy of the pancreatic parenchyma was noted postoperatively in both groups (P < 0.0001), but these changes were more severe in the PG group than the PJ group (P = 0.0018).
  
  
  CONCLUSIONS
  Considering the above postoperative morphological changes, PJ seems to be preferable to PG after pancreaticoduodenectomy.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takeda
authors.forename: Shogo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Chun Man
authors.initials: CM
authors.lastname: Lee
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tanemura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Toru
authors.initials: T
authors.lastname: Kitagawa
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.forename: Kenichi
authors.initials: K
authors.lastname: Wakasa
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000368:Aged; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology* / Q000601:surgery*; D010183:Pancreatic Ducts / Q000473:pathology; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy