Isolated Roux-en-Y reconstruction versus conventional reconstruction after pancreaticoduodenectomy.
BACKGROUND
Pancreatic fistula (PF) is the major cause for morbidity and mortality following pancreaticoduodenectomy. The primary aim of this study was to compare the occurrence rate of postoperative PF between isolated Roux-en-Y reconstruction (RYR) and conventional reconstruction (CR) after pancreaticoduodenectomy.


METHODS
Data of 43 patients who underwent RYC were compared with those of a pair-matched equal number of patients undergoing CR. We also performed a meta-analysis of comparative studies of the two procedures.


RESULTS
The case-matched analysis showed no significant difference in PF occurrence between RYR and CR groups (23.3% versus 25.6%; P = 0.80). Meta-analysis of 1498 patients further confirmed this finding, showing a pooled odds ratio of 1.14 (95% confidence intervals, 0.82-1.58; P = 0.43).


CONCLUSIONS
The use of RYR for pancreaticojejunostomy does not seem to decrease the occurrence rate of postoperative PF in patients undergoing pancreaticoduodenectomy.
Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China.
De-Bang
DB
Li
Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China.
Chen
C
Chai
Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China.
Long
L
Cao
Department of Hepato-Biliary-Pancreato-Vascular Surgery, the First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China. Electronic address: zhouymsxy@sina.cn.
Yan-Ming
YM
Zhou
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000453:epidemiology*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies
Isolated jejunal loop; Pancreatic fistula; Pancreaticoduodenectomy; Pancreaticojejunostomy; Roux-en Y