Modified technique of pancreaticojejunal anastomosis with invagination following pancreaticoduodenectomy: a cohort study

World J Surg. 2008 Dec;32(12):2695-700. doi: 10.1007/s00268-008-9760-0.

Abstract

Background: Leakage from pancreatic anastomoses remains the single most important morbidity after pancreaticoduodenectomy and contributes to prolonged hospitalization and mortality. This observational cohort study reported the surgical outcome of a modified invagination technique of pancreaticojejunostomy after pancreaticoduodenectomy.

Methods: Between December 2001 and December 2007, a total of 52 consecutive patients underwent elective pancreaticoduodenectomy for benign or malignant pathologies of the pancreas or the periampullary region in a tertiary referral center. All patients underwent our modified invagination technique of pancreaticojejunostomy regardless of the characteristics of the pancreatic stump. Data were collected prospectively.

Results: The mean hospital stay was 12.6 +/- 3.2 days. The incidence of overall surgical complications was 9.6%. No patient developed pancreatic fistula. One patient (1.9%) died of respiratory failure on postoperative day 7.

Conclusions: We reported our pancreaticojejunostomy anastomosis technique with a pancreatic fistula rate of 0% and low intra-abdominal complication rate. The favorable results of this technique warrant further investigation in large prospective cohort studies and prospective randomized controlled studies.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreatic Diseases / complications
  • Pancreatic Diseases / pathology
  • Pancreatic Diseases / surgery*
  • Pancreaticoduodenectomy*
  • Pancreaticojejunostomy / adverse effects
  • Pancreaticojejunostomy / methods*
  • Risk Factors
  • Suture Techniques
  • Treatment Outcome