Peng's binding pancreaticojejunostomy after pancreaticoduodenectomy: a French prospective study.
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.
Buc
Emmanuel
E
Service de Chirurgie Digestive et Hépatobiliaire, CHU Clermont-Ferrand, Hôtel Dieu-Bd Léon Malfreyt, 63058 Clermont-Ferrand, France. ebuc@chu-clermontferrand.fr
Flamein
Renaud
R
Golffier
Claudio
C
Dubois
Anne
A
Nagarajan
Ganesh
G
Futier
Emmanuel
E
Pezet
Denis
D
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