title: Pancreaticogastrostomy following distal pancreatectomy prevents pancreatic fistula-related complications.
abstract: BACKGROUND
  The most common postoperative complication after distal pancreatectomy (DP) is still postoperative pancreatic fistula (POPF), which is closely associated with other major complications and remains an unsolved problem.
  
  
  METHODS
  This retrospective study included 47 consecutive patients who underwent a distal pancreatectomy with (DP-PG group, n = 21) or without (DP group, n = 26) duct-to-mucosa pancreaticogastrostomy from June 2010 to May 2012. Clinical data including POPF-related complications (POPF, fluid collection, intra-abdominal abscess, bleeding and delayed gastric emptying) as a primary endpoint were compared between the two groups.
  
  
  RESULTS
  The frequencies of POPF-related complications as well as overall POPF and complications in the DP-PG group were lower than in the DP group (P = 0.037, P < 0.001, respectively). The 30 days morbidity after hospital discharge in the DP-PG group was less than in the DP group (P = 0.014). In both groups median hospital stay was similar. Although additional time needed for pancreaticogastrostomy was 35 (20-55) min, there was no difference in operative times. Patients in the DP group had a higher medical cost for hospitalization than the DP-PG group (P = 0.048).
  
  
  CONCLUSIONS
  Pancreaticogastrostomy as an additional procedure following distal pancreatectomy was associated with a reduced rate of POPF-related complications that resulted in relatively lower medical cost for hospitalization.
authors: Department of Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan.
authors: Hiroaki
authors: H
authors: Yanagimoto
authors: Sohei
authors: S
authors: Satoi
authors: Hideyoshi
authors: H
authors: Toyokawa
authors: Tomohisa
authors: T
authors: Yamamoto
authors: Satoshi
authors: S
authors: Hirooka
authors: Jun
authors: J
authors: Yamao
authors: So
authors: S
authors: Yamaki
authors: Hironori
authors: H
authors: Ryota
authors: Yoichi
authors: Y
authors: Matsui
authors: A-Hon
authors: AH
authors: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000150:complications*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies
keywords: Distal pancreatectomy; Medical cost; Pancreatic fistula-related complication; Pancreaticogastrostomy