Pancreaticogastrostomy Following Pancreatoduodenectomy

Overview

Journal Ann Surg

Specialty General Surgery

Date 1988 Mar 1

PMID 3345112

Citations 13

Authors

P Icard

F Dubois

Affiliations

Soon will be listed here.

Abstract

Operative death following pancreatoduodenectomy results essentially from a pancreatojejunal anastomosis leakage. Pancreaticogastrostomy has been used infrequently. Seventeen patients (12 with malignant tumors and 5 with chronic pancreatitis) have undergone pancreaticogastrostomy following pancreatoduodenectomy. There was no operative mortality rate and no pancreaticogastrostomy leakage. Our data agree with data concerning pancreaticogastrostomy published in literature; cumulative mortality rate including our results is 4.5% (6 out of 134 patients) with only one transient benign pancreatic fistula reported. Many advantages offered by this method can explain these positive results including trypsine neutralization by gastric acidity and the possibility of nasogastric aspiration on contact with the anastomosis. Furthermore, permeability of the pancreatic duct can be easily verified by endoscopic examination. However, external pancreatic insufficiency does not seem to occur in long-term follow-up. These results suggest that this simple and safe method merits a more widespread application.

Citing Articles

Modified Technique for Wirsung-Pancreatogastric Anastomosis after Pancreatoduodenectomy: A Single Center Experience and Systematic Review of the Literature.

Bizzoca C, Fedele S, Lippolis A, Aquilino F, Castellana M, Basile M J Clin Med. 2021; 10(14).

PMID: 34300229 PMC: 8303560. DOI: 10.3390/jcm10143064.

Comparative long-term outcomes for pancreatic volume change, nutritional status, and incidence of new-onset diabetes between pancreatogastrostomy and pancreatojejunostomy after pancreaticoduodenectomy.

Kwak B, Choi H, You Y, Kim D, Hong T Hepatobiliary Surg Nutr. 2020; 9(3):284-295.

PMID: 32509814 PMC: 7262622. DOI: 10.21037/hbsn.2019.04.18.

Different types of pancreatico-enteric anastomosis.

Barreto S, Shukla P Transl Gastroenterol Hepatol. 2017; 2:89.

PMID: 29264427 PMC: 5723729. DOI: 10.21037/tgh.2017.11.02.

Late complications after pancreaticoduodenectomy with pancreaticogastrostomy.

Bock E, Hurtuk M, Shoup M, Aranha G J Gastrointest Surg. 2012; 16(5):914-9.

PMID: 22374385 DOI: 10.1007/s11605-011-1805-2.

The challenge of pancreatic anastomosis.

Kleespies A, Albertsmeier M, Obeidat F, Seeliger H, Jauch K, Bruns C Langenbecks Arch Surg. 2008; 393(4):459-71.

PMID: 18379817 DOI: 10.1007/s00423-008-0324-4.

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