Efficacy of non-stented pancreaticojejunostomy demonstrated in the hard pancreas.
OBJECTIVE
The aim of this study was to compare hard and soft pancreas for short-term complications of pancreaticoduodenectomy performed with a duct-to-mucosa anastomosis of pancreaticojejunostomy without a stenting tube.


METHODS
We investigated 156 patients with pancreaticojejunostomy who were classified into two groups of hard pancreas (group A: 79) and soft pancreas (group B: 77). Outcomes, including complications and operative procedures, are reported.


RESULTS
There were no differences between groups A and B for median age, gender, performance status. Biliary drainage ratio and disease classification of Groups A and B were statistically different. In preoperative status, there were no differences in Body Mass Index, total bilirubin, albumin, hemoglobin, creatinine, and PFD. Group B had lower HbA1C levels than group A. In operative procedures, there were no differences in operative times and blood loss, but group B had longer postoperative hospital days than group A. On operative results, there were no differences in mortality, delayed gastric emptying, biliary fistula, hemorrhage, cholangitis, lymph leakage, and others. There were significant differences between groups A and B in morbidity (12.7% vs. 35.1%), pancreatic fistula (0% vs. 9.1%), intra-abdominal abscess (1.3% vs. 9.1%).


CONCLUSIONS
Efficacy of pancreaticojejunostomy without a stenting tube for hard pancreas was demonstrated.
Shuji
S
Suzuki
Yuhi
Y
Ozaki
Shin
S
Saida
Satoshi
S
Kaji
Nobusada
N
Koike
Nobuhiko
N
Harada
Tsuneo
T
Hayashi
Mamoru
M
Suzuki
Takafumi
T
Tabuchi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D005355:Fibrosis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010179:Pancreas / Q000473:pathology / Q000601:surgery*; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000601:surgery*; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome