title: [Pancreaticogastrostomy: when and how?]
abstract: BACKGROUND
  Pancreaticojejunostomy and pancreaticogastrostomy are the two techniques for pancreatic anastomosis that are widely established for the reconstruction after pancreaticoduodenectomy. Pancreaticogastrostomy is the most recent and to date less frequently performed method, the history, techniques and indications of which are presented.
  
  
  METHODS
  Review of the literature and current evidence.
  
  
  RESULTS
  Current evidence from randomized controlled trials and meta-analyses does not demonstrate significant differences in complication rates or pancreatic function after pancreaticogastrostomy versus pancreaticojejunostomy.
  
  
  CONCLUSIONS
  Pancreaticogastrostomy is the technically less demanding procedure, offering at least the same level of safety as pancreaticojejunostomy. Minimally invasive and parenchyma-sparing procedures provide new areas of application for this anastomotic technique.
authors.affiliation: DHBW Karlsruhe, Karlsruhe, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Tittelbach-Helmrich
authors.affiliation: Klinik für Chirurgie, UKSH Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. tobias.keck@uksh.de.
authors.forename: T
authors.initials: T
authors.lastname: Keck
authors.affiliation: Klinik für Chirurgie, UKSH Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
authors.forename: U F
authors.initials: UF
authors.lastname: Wellner
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010180:Pancreatectomy / Q000379:methods; D010186:Pancreatic Function Tests; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010193:Pancreaticojejunostomy; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Fistula; Hemorrhage; Pancreaticoduodenectomy; Pancreaticojejunostomy; Surgical anastomosis