Reconstruction by Pancreaticogastrostomy Following Pancreaticoduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Quanning ¹ , PENG Chenghong ² , F Yuezu ¹ , HAN Baosan ² , CHENG Dongfeng ²

1.Department of General Surgery, Tongji Hospital, Tongji University, Shanghai 200065, China;;
2.Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University Medical School, Shanghai 200025, ChinaCorresponding Author: CHEN Quan-ning, E-mail：　qnchen87@yahoo.com.cn;

Corresponding author：

Keywords：

Pancreaticoduodenectomy; Pancreaticogastrostomy; Pancreaticojejunostomy

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Objective 　To evaluate the operative indication and results of pancreaticogastrostomy following pancreaticoduodenectomy.
　Methods 　A retrospective study was carried out on the cases of pancreaticoduodenectomy following pancreaticogastrostomy from Aug. 2005 to Feb. 2008 in Shanghai Tongji Hospital.
　Results 　During this period, 38 cases had undergone pancreaticogastrostomy with pancreaticoduodenectomy. The median operative time was (352.1±78.3) min. The median intraoperative blood transfusion was (911.3±601.4) ml. The median postoperative length of stay was (26.2±12.1) d. Postoperative morbidity was 21.1% (8/38) with no operative death. Pancreatic anastomotic leakage occurred in 1 patient. Delayed gastric emptying occurred in 2 patients. Incision infection occurred in 2 patients. Abdominal fluid collection occurred in 1 patient and pulmonary infection occurred in 2 patients. All of the complications were treated conservatively.
　Conclusion 　Pancreaticogastrostomy is a safer drainage procedure for the pancreatic stump after pancreaticoduodenectomy.

Citation： CHEN Quanning,PENG Chenghong,F Yuezu,HAN Baosan,CHENG Dongfeng. Reconstruction by Pancreaticogastrostomy Following Pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(3): 223-225. doi: Copy

1.	Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes [Ｊ]. Ann Surg, 1997; 226(3):248.
2.	Beger HG, Gansauge F, Schwab M, et al. Pancreatic head resection: the risk for local and systemic complications in 1 315 patients—a monoinstitutional experience [Ｊ]. Am J Surg, 2007; 194:16.
3.	Kleespies A, Albertsmeier M, Obeidat F, et al. The challenge of pancreatic anastomosis [Ｊ]. Langenbecks Arch Surg, 2008; 393(4):459.
4.	Lermite E, Pessaux P, Brehant O, et al. Risk factors of pancreatic fistula and delayed gastric emptying after pancreaticoduodenectomy with pancreaticogastrostomy [Ｊ]. J Am Coll Surg, 2007; 204(4):588.
5.	Tran K, Van Eijck C, Di Carlo V, et al. Occlusion of the pancreatic duct versus pancreaticojejunostomy: a prospective randomized trial [Ｊ]. Ann Surg, 2002; 236(4):422.
6.	Schlitt HJ, Schmidt U, Simunec D, et al. Morbidity and mortality associated with pancreatogastrostomy and pancreatojejunostomy following partial pancreatoduodenectomy [Ｊ]. Br J Surg, 2002; 89(10):1245.
7.	Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 222(4):580.
8.	Aranha GV, Hodul P, Golts E, et al. A comparison of pancreaticogastrostomy and pancreaticojejunostomy following pancreaticoduodenectomy [Ｊ]. J Gastrointest Surg, 2003; 7(5):672.
9.	Bassi C, Falconi M, Molinari E, et al. Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study [Ｊ]. Ann Surg, 2005; 242(6):767.
10.	McKay A, Mackenzie S, Sutherland FR, et al. Meta-analysis of pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy [Ｊ]. Br J Surg, 2006; 93(8):929.
11.	王建玲, 王强, 田志龙. 胰十二指肠切除术的单层胰胃吻合 [Ｊ]. 中国普外基础与临床杂志, 2001; 8(6):416.
12.	刘海, 马勇, 任祖海. 胰腺-胃吻合术在胰十二指肠切除术中的应用(附24例报告) [Ｊ]. 中国普外基础与临床杂志, 2007; 14(2):210.
13.	Tripodi AM, Sherwin CF. Experimental transplantation of the pancreas into the stomach [Ｊ]. Arch Surg, 1934; 28:345.
14.	Waugh JM, Clagett OT. Resection of the duodenum and head of pancreas for carcinoma. An analysis of thirty cases [Ｊ]. Surgery, 1946; 20:224.
15.	〖JP2〗Shinchi H, Takao S, Maemura K, et al. A new technique for pancreaticogastrostomy for the soft pancreas: the transfixing suture method [Ｊ]. J Hepatobiliary Pancreat Surg, 2006; 13(3):212〖JP〗.
16.	Aranha GV. A technique for pancreaticogastrostomy [Ｊ]. Am J Surg, 1998; 175(4):328.
17.	Takano S, Ito Y, Watanabe Y, et al. Pancreaticojejunostomy versus pancreaticogastrostomy in reconstruction following pancreaticoduodenectomy [Ｊ]. Br J Surg, 2000; 87(4):423.
18.	Takao S, Shimazu H, Maenohara S, et al. Modified pancreaticogastrostomy following pancreaticoduodenectomy [Ｊ]. Am J Surg, 1993; 165(3):317.
19.	Payne RF, Pain JA. Duct-to-mucosa pancreaticogastrostomy is a safe anastomosis following pancreaticoduodenectomy [Ｊ]. Br J Surg, 2006; 93(1):73.
20.	Murakami Y, Uemura K, Hayashidani Y, et al. No mortality after 150 consecutive pancreatoduodenctomies with duct-to-mucosa pancreaticogastrostomy [Ｊ]. J Surg Oncol, 2008; 97(3):205.

1. Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes [Ｊ]. Ann Surg, 1997; 226(3):248.
2. Beger HG, Gansauge F, Schwab M, et al. Pancreatic head resection: the risk for local and systemic complications in 1 315 patients—a monoinstitutional experience [Ｊ]. Am J Surg, 2007; 194:16.
3. Kleespies A, Albertsmeier M, Obeidat F, et al. The challenge of pancreatic anastomosis [Ｊ]. Langenbecks Arch Surg, 2008; 393(4):459.
4. Lermite E, Pessaux P, Brehant O, et al. Risk factors of pancreatic fistula and delayed gastric emptying after pancreaticoduodenectomy with pancreaticogastrostomy [Ｊ]. J Am Coll Surg, 2007; 204(4):588.
5. Tran K, Van Eijck C, Di Carlo V, et al. Occlusion of the pancreatic duct versus pancreaticojejunostomy: a prospective randomized trial [Ｊ]. Ann Surg, 2002; 236(4):422.
6. Schlitt HJ, Schmidt U, Simunec D, et al. Morbidity and mortality associated with pancreatogastrostomy and pancreatojejunostomy following partial pancreatoduodenectomy [Ｊ]. Br J Surg, 2002; 89(10):1245.
7. Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 222(4):580.
8. Aranha GV, Hodul P, Golts E, et al. A comparison of pancreaticogastrostomy and pancreaticojejunostomy following pancreaticoduodenectomy [Ｊ]. J Gastrointest Surg, 2003; 7(5):672.
9. Bassi C, Falconi M, Molinari E, et al. Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study [Ｊ]. Ann Surg, 2005; 242(6):767.
10. McKay A, Mackenzie S, Sutherland FR, et al. Meta-analysis of pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy [Ｊ]. Br J Surg, 2006; 93(8):929.
11. 王建玲, 王强, 田志龙. 胰十二指肠切除术的单层胰胃吻合 [Ｊ]. 中国普外基础与临床杂志, 2001; 8(6):416.
12. 刘海, 马勇, 任祖海. 胰腺-胃吻合术在胰十二指肠切除术中的应用(附24例报告) [Ｊ]. 中国普外基础与临床杂志, 2007; 14(2):210.
13. Tripodi AM, Sherwin CF. Experimental transplantation of the pancreas into the stomach [Ｊ]. Arch Surg, 1934; 28:345.
14. Waugh JM, Clagett OT. Resection of the duodenum and head of pancreas for carcinoma. An analysis of thirty cases [Ｊ]. Surgery, 1946; 20:224.
15. 〖JP2〗Shinchi H, Takao S, Maemura K, et al. A new technique for pancreaticogastrostomy for the soft pancreas: the transfixing suture method [Ｊ]. J Hepatobiliary Pancreat Surg, 2006; 13(3):212〖JP〗.
16. Aranha GV. A technique for pancreaticogastrostomy [Ｊ]. Am J Surg, 1998; 175(4):328.
17. Takano S, Ito Y, Watanabe Y, et al. Pancreaticojejunostomy versus pancreaticogastrostomy in reconstruction following pancreaticoduodenectomy [Ｊ]. Br J Surg, 2000; 87(4):423.
18. Takao S, Shimazu H, Maenohara S, et al. Modified pancreaticogastrostomy following pancreaticoduodenectomy [Ｊ]. Am J Surg, 1993; 165(3):317.
19. Payne RF, Pain JA. Duct-to-mucosa pancreaticogastrostomy is a safe anastomosis following pancreaticoduodenectomy [Ｊ]. Br J Surg, 2006; 93(1):73.
20. Murakami Y, Uemura K, Hayashidani Y, et al. No mortality after 150 consecutive pancreatoduodenctomies with duct-to-mucosa pancreaticogastrostomy [Ｊ]. J Surg Oncol, 2008; 97(3):205.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Reconstruction by Pancreaticogastrostomy Following Pancreaticoduodenectomy

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