Clinical evaluation of modified reconstruction method after pancreatoduodenectomy.
OBJECTIVE
The new reconstruction procedure after pancreatoduodenectomy (PD) is described to evaluate its usefulness.


METHODS
The jejunum was made for an end-to-side choledochojejunostomy, and the cut proximal jejunum for approximately 20 cm was led to the pancreatic stump for end-to-end anastomosis with telescoping. Approximately 20 cm of jejunum was created with a side-to-end anastomosis with the stomach, and end-to-side jejuno-jejunostomy for Roux-en Y reconstruction. As a postoperative course, separated loop method (SL, n=38) was evaluated by comparing pancreatogastrostomy (PG, n=31) and Imanaga method (IM, n=26).


RESULTS
On SL, PG and IM cases, the high amylase level in drainage fluid was noted in 2.6%, 6.5% and 19.2%, respectively. The delayed gastric emptying was seen in PG and IM, but not in SL. Serum albumin levels were similar, but cholinesterase and total cholesterol levels were significant better in SL.


CONCLUSIONS
SL method is safe for complications after PD.
Osada
Shinji
S
Surgical Oncology, Gifu University School of Medicine, Gifu city, Japan. sting@gifu-u.ac.jp
Sanada
Yuichi
Y
Tanaka
Yoshihiro
Y
Ikawa
Aiko
A
Tokuyama
Yasuharu
Y
Okumura
Naoki
N
Hosono
Yoshiki
Y
Nonaka
Kenichi
K
Takahashi
Takao
T
Yamaguchi
Kazuya
K
Yoshida
Kazuhiro
K
D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D001650:Bile Duct Neoplasms / Q000601:surgery*; D002768:Choledochostomy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome