title: The effect of modified pancreaticojejunostomy for reducing the pancreatic fistula after pancreaticoduodenectomy.
abstract: OBJECTIVE
  Pancreatic fistula (PF) has traditionally been a source of significant morbidity and mortality after pancreaticoduodenectomy (PD). External drainage of pancreatic duct with stent and Blumgart anastomosis had reduced PF after PD in some studies. We applied compounding described two methods for pancreaticojejunostomy (PJ) during PD, and investigated the effectiveness of this modified PJ technique to prevent PF.
  
  
  METHODS
  Between March 2002, and March 2013, 90 patients who underwent PD were enrolled. The patients were divided into 2 groups according to pancreatienterostomy method. Group 1 contain patients who did not undergo modified PJ (n=70) compared with group 2 (n=20) those who did undergo the modified PJ technique. We compared clinical data between two groups.
  
  
  RESULTS
  No differences were noted in the demographics and operation-related factors, between the 2 groups. A PF occurred in 38 of 70 patients in group 1 (54.3%) and in 2 of 20 in group 2 (10.0%). Group 2 had a significantly lower incidence of PF (P=.0016), and these fistulas were classified as being grade A using the International Study Group on Pancreatic Fistula Definition. Mortality in group 1 was 10.0% and no mortality in group 2.
  
  
  CONCLUSIONS
  External drainage with Blumgart method of PJ showed reducing high grade PF after PD.
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Kim
authors.forename: Kwang Yeol
authors.initials: KY
authors.lastname: Paik
authors.forename: Wook
authors.initials: W
authors.lastname: Kim
authors.forename: Eung Kook
authors.initials: EK
authors.lastname: Kim
mesh_terms: D000368:Aged; D004322:Drainage / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000401:mortality; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome