title: Pancreaticojejunostomy vs. pancreaticogastrostomy following pancreaticoduodenectomy: results of comparative study.
abstract: OBJECTIVE
  Several techniques have been proposed for reconstructing pancreatico-digestive continuity, which the first goal is reducing the rate of pancreatic leakage after pancreaticoduodenectomy. Only a limited number studies have been carried out. Our objective is to compare the results of pancreaticojejunostomy versus pancreaticogastrostomy following pancreaticoduodenectomy.
  
  
  METHODS
  This is a retrospective and comparative study about 80 patients who underwent pancreaticoduodenectomy. These patients were divided into two groups: pancreaticojejunostomy (group PJ) and pancreaticogastrostomy (group PG).
  
  
  RESULTS
  The PJ group included 39 patients, while 41 patients were included in the PG group. There were no differences between the two groups concerning: patients' demographics, risk factors, indication, mean duration of surgery, texture of pancreatic tissue, need for intraoperative blood transfusion and postoperative prophylactic octreotide. Overall, the mortality postoperative rate was 7.5% (N.=6), the incidence of surgical complications was 50% (51.3% in PJ, 48.8% in PG; P=0.823, not significant). Pancreatic fistula was the most frequent complication, occurring in 17.5% of patients (25.6% in PJ and 9.8% in PG; P=0.062, almost significant). 7.7% of patients who underwent PJ and 14.6% of patients who underwent PG required a second surgical intervention (P=0.326, not significant). There were no differences between the two groups PG and PJ concerning: Postoperative hemorrhage (P=0.63), biliary fistula (P=0.09), acute pancreatitis (P=0.95), delayed gastric emptying (P=0.33). The mean postoperative hospitalisation period stay was similar in both groups (P=0.63)
  
  
  CONCLUSIONS
  There were not any significant differences between the two groups in the overall postoperative complication rate, the incidence of postoperative haemorrhage, biliary fistula, acute pancreatitis, and delayed.
authors.affiliation: Department of Digestive Surgery 'A', La Rabta Hospital University, Tunis, Tunisia. aminmakni@msn.com
authors.forename: A
authors.initials: A
authors.lastname: Makni
authors.forename: H
authors.initials: H
authors.lastname: Bedioui
authors.forename: M
authors.initials: M
authors.lastname: Jouini
authors.forename: F
authors.initials: F
authors.lastname: Chebbi
authors.forename: R
authors.initials: R
authors.lastname: Ksantini
authors.forename: F
authors.initials: F
authors.lastname: Fetirich
authors.forename: W
authors.initials: W
authors.lastname: Rebai
authors.forename: A
authors.initials: A
authors.lastname: Daghfous
authors.forename: S
authors.initials: S
authors.lastname: Ayedi
authors.forename: M
authors.initials: M
authors.lastname: Kacem
authors.forename: Z
authors.initials: Z
authors.lastname: Ben Safta
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000465:Algorithms; D000714:Anastomosis, Surgical / Q000379:methods; D001658:Biliary Fistula / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D005746:Gastric Emptying; D005774:Gastrostomy / Q000009:adverse effects* / Q000401:mortality; D006470:Hemorrhage / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy / Q000009:adverse effects* / Q000401:mortality; D010195:Pancreatitis / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome