title: Clinical evaluation of modified reconstruction method after pancreatoduodenectomy.
abstract: 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.
authors.affiliation: Surgical Oncology, Gifu University School of Medicine, Gifu city, Japan. sting@gifu-u.ac.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Osada
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sanada
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Aiko
authors.initials: A
authors.lastname: Ikawa
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tokuyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hosono
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nonaka
authors.forename: Takao
authors.initials: T
authors.lastname: Takahashi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshida
mesh_terms: 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