Use of isolated Roux loop for pancreaticojejunostomy reconstruction after pancreaticoduodenectomy.
OBJECTIVE
To evaluate the efficacy of the isolated Roux loop technique in decreasing the frequency of pancreaticojejunal anastomosis failure.


METHODS
We retrospectively reviewed 88 consecutive patients who underwent pancreaticoduodenectomy (standard or pylorus-preserving). Single jejunal loop was used in 42 patients (SL group) while isolated Roux loop was used in 46 patients (RL group). Demographic characteristics (age, gender) and perioperative results (major/minor complications, mortality, hospital stay) were compared between the two groups.


RESULTS
Mortality was almost equal in both groups and overall mortality was 2.27%. Leak rate from the pancreaticojejunal anastomosis and hospital stay were lower in the RL group without significant difference. Morbidity was 39.1% in the RL group, insignificantly higher than the SL group. Operative time was almost 30 min longer in the RL group.


CONCLUSIONS
The isolated Roux loop, although an equally safe alternative, does not present advantages over the traditional use of a single jejunal loop. Randomized controlled studies are required to further clarify its efficacy.
Ballas
Konstantinos
K
Second Propedeutical Department of Surgery, Ippokratio General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos str, Thessaloniki, 54642, Thessaloniki, Greece.
Symeonidis
Nikolaos
N
Rafailidis
Savvas
S
Pavlidis
Theodoros
T
Marakis
Georgios
G
Mavroudis
Nikolaos
N
Sakantamis
Athanasios
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000401:mortality; D010193:Pancreaticojejunostomy / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome