Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: Results of a prospective randomized trial

Claudio Bassi, Massimo Falconi, Enrico Molinari, William Mantovani, Giovanni Butturini, Andrew A. Gumbs, Roberto Salvia, Paolo Pederzoli

Research output: Contribution to journalArticle

Abstract

Background. Anastomotic failure is still a significant problem that affects the outcome of pancreaticoduodenectomy. There have been many techniques proposed for the reconstruction of pancreatic digestive continuity, but there have been few prospective and randomized studies that compare their efficacy. Methods. In the current work, 144 patients who underwent a pancreaticoduodenectomy with soft residual tissue were assigned randomly to receive either a duct-to-mucosa anastomosis (group A) or a 1-layer end-to-side pancreaticojejunostomy (group B). Results. The 2 treatment groups were found not to have any differences in regards to vital statistics, underlying disease, or operative techniques. The postoperative course was complicated in 54% of the 144 patients, with a comprehensive incidence of abdominal complications in 36% (group A, 35%; group B, 38%; P = not significant). The principal complication was pancreatic fistulas, which occurred in 14% of patients (group A, 13%; group B, 15%; P = not significant). Two patients (2%) required reoperation; the postoperative mortality rate was 1%. Conclusion. The 2 methods that were studied revealed no significant difference the rate of complications.

Original languageEnglish
Pages (from-to)766-771
Number of pages6
JournalSurgery
Volume134
Issue number5
DOIs
Publication statusPublished - Nov 2003

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Pancreaticojejunostomy
Pancreaticoduodenectomy
Mucous Membrane
Pancreatic Fistula
Vital Statistics
Reoperation
Prospective Studies
Mortality
Incidence

ASJC Scopus subject areas

  • Surgery

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Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy : Results of a prospective randomized trial. / Bassi, Claudio; Falconi, Massimo; Molinari, Enrico; Mantovani, William; Butturini, Giovanni; Gumbs, Andrew A.; Salvia, Roberto; Pederzoli, Paolo.

In: Surgery, Vol. 134, No. 5, 11.2003, p. 766-771.

Research output: Contribution to journalArticle

Bassi, Claudio ; Falconi, Massimo ; Molinari, Enrico ; Mantovani, William ; Butturini, Giovanni ; Gumbs, Andrew A. ; Salvia, Roberto ; Pederzoli, Paolo. / Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy : Results of a prospective randomized trial. In: Surgery. 2003 ; Vol. 134, No. 5. pp. 766-771.
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AB - Background. Anastomotic failure is still a significant problem that affects the outcome of pancreaticoduodenectomy. There have been many techniques proposed for the reconstruction of pancreatic digestive continuity, but there have been few prospective and randomized studies that compare their efficacy. Methods. In the current work, 144 patients who underwent a pancreaticoduodenectomy with soft residual tissue were assigned randomly to receive either a duct-to-mucosa anastomosis (group A) or a 1-layer end-to-side pancreaticojejunostomy (group B). Results. The 2 treatment groups were found not to have any differences in regards to vital statistics, underlying disease, or operative techniques. The postoperative course was complicated in 54% of the 144 patients, with a comprehensive incidence of abdominal complications in 36% (group A, 35%; group B, 38%; P = not significant). The principal complication was pancreatic fistulas, which occurred in 14% of patients (group A, 13%; group B, 15%; P = not significant). Two patients (2%) required reoperation; the postoperative mortality rate was 1%. Conclusion. The 2 methods that were studied revealed no significant difference the rate of complications.

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