title: Pancreaticogastrostomy in patients with considerably dilated pancreatic ducts.
abstract: OBJECTIVE
  Patency of pancreaticogastrostomy (PG) is one of the most important factors affecting the function of the remnant pancreas and quality of life. We evaluated the early postoperative changes in pancreatic duct dilation after pancreaticoduodenectomy (PD) and PG with duct-to-mucosa anastomosis in patients with remarkably dilated pancreatic ducts.
  
  
  METHODS
  We retrospectively analyzed 26 patients who had remarkably dilated pancreatic ducts (diameter, ≥7 mm) and who underwent PD followed by PG. They were divided into 2 groups on the basis of the endoscopic findings of the anastomotic orifice of PG: Group A, clear pancreatic duct orifice with pancreatic juice output; and Group B, unclear pancreatic duct orifice with pancreatic juice output.
  
  
  RESULTS
  The mean diameter of the duct of the remnant pancreas after the surgery was smaller in Group A than in Group B. With regards to postoperative pancreatic exocrine function, there was no significant difference between the 2 groups.
  
  
  CONCLUSIONS
  Invagination with duct-to-mucosa anastomosis is a useful technique to prevent pancreatic leakage; however, it is difficult to prevent inflammation and fibrosis around the anastomotic site of PG, and this can lead to anastomotic stricture in patients with a remarkably dilated pancreatic duct (diameter ≥7 mm).
authors: Department of Surgery, Social Insurance Yokohama Central Hospital, Yokohama, Japan. ooida.takatsugu@yokochu.jp
authors: Takatsugu
authors: T
authors: Oida
authors: Kenji
authors: K
authors: Mimatsu
authors: Hisao
authors: H
authors: Kano
authors: Atsushi
authors: A
authors: Kawasaki
authors: Youichi
authors: Y
authors: Kuboi
authors: Nobutada
authors: N
authors: Fukino
authors: Kazutoshi
authors: K
authors: Kida
authors: Sadao
authors: S
authors: Amano
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic; D004108:Dilatation, Pathologic; D004724:Endoscopy; D005260:Female; D005355:Fibrosis; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome