title: Peng's binding pancreaticojejunostomy after pancreaticoduodenectomy: a French prospective study.
abstract: BACKGROUND
  Pancreatic fistula (PF) is the single most important complication after pancreaticoduodenectomy. Recently, a 0% rate of PF was reported using a binding pancreaticojejunostomy with intussusception of the pancreatic stump. The aim of this study was to assess the safety of this new binding pancreaticojejunostomy in condition most susceptible to PF, i.e. soft pancreas and non-dilated main pancreatic duct.
  
  
  METHODS
  Forty-five consecutive patients with soft pancreas and non-dilated main pancreatic duct underwent a binding pancreaticojejunostomy. Post-operative PF was defined according to the International Study Group of Pancreatic Fistula.
  
  
  RESULTS
  Four patients (8.9%) developed a PF. In one case, PF developed on post-operative day 3 due to a technical deficiency. In the three other cases, pancreatic fistula developed after the tenth post-operative day; all the patients had local and/or general co-morbidities before PF occurrence.
  
  
  CONCLUSIONS
  Binding pancreaticojejunostomy according to Peng is a safe and secure technique that improves the rate of pancreatic fistula, especially in case of soft texture of the pancreas remnant. However, a 0% rate seems to be hard to achieve because other abdominal and general complications are frequent and can lead to secondary leakage of the pancreatic anastomosis.
authors.affiliation: Service de Chirurgie Digestive et Hépatobiliaire, CHU Clermont-Ferrand, Hôtel Dieu-Bd Léon Malfreyt, 63058 Clermont-Ferrand, France. ebuc@chu-clermontferrand.fr
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Buc
authors.forename: Renaud
authors.initials: R
authors.lastname: Flamein
authors.forename: Claudio
authors.initials: C
authors.lastname: Golffier
authors.forename: Anne
authors.initials: A
authors.lastname: Dubois
authors.forename: Ganesh
authors.initials: G
authors.lastname: Nagarajan
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Futier
authors.forename: Denis
authors.initials: D
authors.lastname: Pezet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery*; D010185:Pancreatic Fistula / Q000209:etiology* / Q000517:prevention & control; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome