| Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study. | |
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MedLine Citation:
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PMID: 16327486 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the results of pancreaticogastrostomy versus pancreaticojejunostomy following pancreaticoduodenectomy in a prospective and randomized setting. SUMMARY BACKGROUND DATA: While several techniques have been proposed for reconstructing pancreatico-digestive continuity, only a limited number of randomized studies have been carried out. METHODS: A total of 151 patients undergoing pancreaticoduodenectomy with soft residual tissue were randomized to receive either pancreaticogastrostomy (group PG) or end-to-side pancreaticojejunostomy (group PJ). RESULTS: The 2 treatment groups showed no differences in vital statistics or underlying disease, mean duration of surgery, and need for intraoperative blood transfusion. Overall, the incidence of surgical complications was 34% (29% in PG, 39% in PJ, P = not significant). Patients receiving PG showed a significantly lower rate of multiple surgical complications (P = 0.002). Pancreatic fistula was the most frequent complication, occurring in 14.5% of patients (13% in PG and 16% in PJ, P = not significant). Five patients in each treatment arm required a second surgical intervention; the postoperative mortality rate was 0.6%. PG was favored over PJ due to significant differences in postoperative collections (P = 0.01), delayed gastric emptying (P = 0.03), and biliary fistula (P = 0.01). The mean postoperative hospitalization period stay was comparable in both groups. CONCLUSIONS: When compared with PJ, PG did not show any significant differences in the overall postoperative complication rate or incidence of pancreatic fistula. However, biliary fistula, postoperative collections and delayed gastric emptying are significantly reduced in patients treated by PG. In addition, pancreaticogastrostomy is associated with a significantly lower frequency of multiple surgical complications. |
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Authors:
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Claudio Bassi; Massimo Falconi; Enrico Molinari; Roberto Salvia; Giovanni Butturini; Nora Sartori; William Mantovani; Paolo Pederzoli |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Annals of surgery Volume: 242 ISSN: 0003-4932 ISO Abbreviation: Ann. Surg. Publication Date: 2005 Dec |
Date Detail:
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Created Date: 2005-12-05 Completed Date: 2006-01-17 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: United States |
Other Details:
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Languages: eng Pagination: 767-71, discussion 771-3 Citation Subset: AIM; IM |
Affiliation:
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Surgical and Gastroenterological Department, Endocrine and Pancreatic Unit, Hospital G.B. Rossi, University of Verona, 37134 Verona, Italy. claudio.bassi@univr.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Chi-Square Distribution Female Gastrostomy* Humans Incidence Intraoperative Complications / epidemiology Male Middle Aged Pancreatic Neoplasms / surgery* Pancreaticoduodenectomy* Pancreaticojejunostomy* Postoperative Complications / epidemiology Prospective Studies Treatment Outcome |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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