Results of pancreaticojejunal end-to-side anastomosis using the invagination method without a pancreatic stenting tube.
OBJECTIVE
Perioperative management of pancreaticoduodenectomy (PD) is a constant dilemma and challenging for gastrointestinal surgeons. Postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE) are of particular concern, and the onset of these conditions indicates a prolonged postoperative stay (POS). The procedure and postoperative outcomes of pancreaticojejunostomy performed at our hospital are reported.


METHODS
POPF, DGE, and POS were investigated in 54 patients who had undergone PD at our hospital since June 2007. Pancreaticojejunal end-to-side anastomosis using the invagination method without a stenting tube and without duct-to-mucosa anastomosis was performed in all patients, regardless of pancreatic duct diameter.


RESULTS
There were 26 patients (48.2%) without POPF, 24 (44.4%) with grade A, 4 (7.4%) with grade B, and none with grade C. The mean POS was 28.3 days. DGE was observed in 4 patients (7.4%) who underwent pylorus-preserving PD (PpPD). There were 34 patients with a soft pancreas. None of the patients experienced intraperitoneal bleeding or abscess, and no surgery-related deaths occurred.


CONCLUSIONS
The reconstructive pancreaticojejunostomy procedure performed at our hospital appears to be safe and convenient, and we plan to collect additional data, including assessments of the function of the remaining pancreas, in the future.
Ikuo
I
Watanobe
Satoshi
S
Omori
Syozo
S
Miyano
Taijiro
T
Kosaka
Michio
M
Machida
Toshiaki
T
Kitabatake
Minoru
M
Fujisawa
Kuniaki
K
Kojima
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018589:Gastroparesis / Q000209:etiology / Q000517:prevention & control; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome