title: Outcomes comparing a pancreaticogastrostomy (PG) and a pancreaticojejunostomy (PJ) after a pancreaticoduodenectomy (PD).
abstract: BACKGROUND
  The advantage of a pancreaticogastrostomy (PG) over a pancreaticojejunostomy (PJ) after a pancreaticoduodenectomy (PD) is not clear.
  
  
  OBJECTIVE
  The aim of the present study was to compare the pancreatic fistula (PF, defined according to the International Study Group for Pancreatic Fistula classification) rate and other complications between both methods.
  
  
  METHODS
  Retrospective analysis of prospectively collected data of 424 [median: 65 years (17-83)] patients who underwent PG (239, 56.4%) and PJ (185, 43.6%) reconstruction between January 2005 and December 2009.
  
  
  RESULTS
  PF occurred in 55 (23.5%) in the PG and 30 (16.2%, P= 0.067) patients in the PJ group. Grade A PF occurred in 19 (7.9%), B in 22 (9.2%) and C in 14 (5.8%) in the PG compared with 5 (2.7%), 12 (6.5%) and in 13 (7.0%), respectively, in the PJ group. The median hospital was 10 days in both groups. The morbidity was higher in the PG group (108, 45.2 vs. 62, 33.5%, P= 0.015). However, there was no significant difference in the 90-day mortality between both groups (PG-17, 7.0% vs. PJ-16, 8.6%, P= 0.558).
  
  
  CONCLUSIONS
  There was no difference in the overall PF rate, hospital stay and overall mortality between PG and PJ reconstruction methods. However, the grade A PF rate was higher in the PG group.
authors.affiliation: Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK.
authors.forename: Somaiah
authors.initials: S
authors.lastname: Aroori
authors.forename: Puneet
authors.initials: P
authors.lastname: Puneet
authors.forename: Simon R
authors.initials: SR
authors.lastname: Bramhall
authors.forename: Paolo
authors.initials: P
authors.lastname: Muiesan
authors.forename: A David
authors.initials: AD
authors.lastname: Mayer
authors.forename: Darius F
authors.initials: DF
authors.lastname: Mirza
authors.forename: John C
authors.initials: JC
authors.lastname: Buckels
authors.forename: John
authors.initials: J
authors.lastname: Isaac
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004739:England; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000209:etiology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult