A simple pancreaticojejunostomy technique for hard pancreases using only two transpancreatic sutures with buttresses: a comparison with the previous pancreaticogastrostomy and dunking methods.
10.4174/astr.2016.90.2.64
- Author:
Eun Young KIM
1
;
Young Kyoung YOU
;
Dong Goo KIM
;
Tae Ho HONG
Author Information
1. Department of Hepatobiliary and Pancreas Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. gshth@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Pancreas;
Pancreaticoduodenectomy;
Pancreaticojejunostomy
- MeSH:
Humans;
Methods*;
Operative Time;
Pancreas*;
Pancreatic Fistula;
Pancreaticoduodenectomy;
Pancreaticojejunostomy*;
Sutures*
- From:Annals of Surgical Treatment and Research
2016;90(2):64-71
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: In this study, we introduced a novel technique, the pancreaticojejunostomy (PJ), which uses only two transpancreatic sutures with buttresses (PJt), and compared the surgical outcomes with previously used methods, especially for hard pancreases. METHODS: A total of 101 patients who underwent pancreaticoduodenectomy with hard pancreases were enrolled and divided into 3 groups according to the method of pancreaticoenteric anastomosis: 30 patients (29.7%) underwent the conventional dunking method (Du), 31 patients (30.7%) underwent pancreaticogastrostomy using transpancreatic sutures (PGt) and 40 patients (39.6%) underwent PJ using transpancreatic sutures (PJt). The surgical outcomes were compared according to the type of anastomosis to analyze the feasibility and ease of each technique. RESULTS: The overall operative time was shorter in the PJt group (325.1 +/- 63.8 minutes) than in the PGt group (367.3 +/- 70.5 minutes) or the Du group (412.0 +/- 38.2 minutes, P < 0.001). In terms of pancreaticoenteric anastomosis time, it was also shorter in the PJt group (10.3 +/- 3.5 minutes) than in the Du group (20.7 +/- 0.7 minutes) or the PGt group (16.8 +/- 5.4 minutes, P = 0.005). Significant postoperative pancreatic fistula (POPF) developed in 2 cases (6.7%) in the Du group, whereas there were no POPF cases in the PGt or PJt groups (P = 0.086). Overall postoperative morbidities occurred in 31 cases (30.7%), and there were no significant differences among the 3 groups (P = 0.692). CONCLUSION: The novel PJ technique, which uses only two transpancreatic sutures with buttresses, is a very simple, easy and secure method for hard pancreases and can be performed in a shorter amount of time compared with conventional methods.
