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No mortality after 150 consecutive pancreatoduodenctomies with duct‐to‐mucosa pancreaticogastrostomy
Author(s) -
Murakami Yoshiaki,
Uemura Kenichiro,
Hayashidani Yasuo,
Sudo Takeshi,
Hashimoto Yasushi,
Nakagawa Naoya,
Ohge Hiroki,
Sueda Taijiro
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20903
Subject(s) - medicine , anastomosis , surgery , pancreatic fistula , pancreatic duct , blood loss , blood transfusion , fistula , mortality rate , pancreatic juice , leak , pancreaticoduodenectomy , pancreas , pancreatitis , resection , environmental engineering , engineering
Background and Objectives The mortality rate after pancreatoduodenectomy (PD) remains 0–5% at major surgical centers with the major cause of operative death being a leak at the pancreaticojejunal anastomosis. The aim of this retrospective study was to evaluate the safety of duct‐to‐mucosa pancreaticogastrostomy (PG) at a single institute. Methods One hundred fifty consecutive patients with pancreato‐biliary diseases undergoing duct‐to‐mucosa PG following PD between 1995 and 2005 were evaluated. One hundred forty patients underwent a pylorus‐preserving PD and 10 patients underwent a conventional PD (Whipple operation). External drainage of pancreatic juice was performed in 77 cases. Results The mean operating time was 378 min and the mean blood loss was 1,640 ml. Blood transfusion was not required in 97 patients (65%). The morbidity rate was 50% (75/150), but the mortality rate was 0%. Pancreatic fistulae occurred in 11 patients (7%). Gender, age, operative procedure, portal vein resection, external drainage of the pancreatic juice, operative time, blood loss and blood transfusion did not affect the rate of pancreatic fistula. The rate of pancreatic fistulae tended to be lower in pancreatic carcinoma (3%) than non‐pancreatic carcinoma (11%). Conclusions Duct‐to‐mucosa PG is a safe procedure for reconstruction following PD. J. Surg. Oncol. 2008;97:205–209. © 2007 Wiley‐Liss, Inc.