Open pancreaticogastrostomy after pancreaticoduodenectomy: A pilot study

Claudio Bassi, Giovanni Butturini, Roberto Salvia, Stefano Crippa, Massimo Falconi, Paolo Pederzoli

Research output: Contribution to journalArticle

Abstract

Management of the pancreatic stump following pancreaticoduodenectomy (PD) has always been a main source of concern among pancreatic surgeons. The present pilot study describes the reconstructive technique of anterior transgastric pancreaticogastrostomy (PG) after pylorus-preserving PD. Outcome in 50 patients with "soft" residual parenchyma treated with this technique is also reported. The average duration of the intervention was 351 minutes (range, 240-360); only two patients needed intraoperative transfusion with 2 units of blood. The postoperative period involved complications in 15 cases (30%). In particular, four patients developed pancreatic fistulas (8%), which were grade C in three cases (6%) and grade B in one patient (2%). Two patients (4%) presented with enteric fistula from erosion from a drain. Two patients experienced perianastomotic fluid collections associated with delayed gastric emptying (4%) and a clinically silent 5-cm abdominal collection was observed in an additional case. Bleeding of a gastric ulcer was treated in one case and four patients developed bronchopneumonia. None of the complications required a second surgical intervention and there were no deaths. One patient with a symptomatic fluid collection was treated by ultrasound-guided cutaneous drainage. The mean hospitalization time was 11.1 days (range, 8-25 days). The results obtained in this pilot study appear encouraging and merit further analysis in a randomized comparative trial.

Original languageEnglish
Pages (from-to)1072-1080
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume10
Issue number7
DOIs
Publication statusPublished - Jul 2006

Keywords

  • Pancreatic surgery
  • Pancreaticoduodenectomy
  • Pancreaticogastrostomy
  • Pancreaticojejunostomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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