Pancreaticogastrostomy after Pancreaticoduodenectomy Using Twin Square Wrapping with Duct-to-Mucosa Anastomosis
| Autor: | Satoshi Iino, Sonshin Takao, Shinichi Ueno, Hiroyuki Shinchi, Hiroshi Kurahara, Sumiya Ishigami, Akihiro Nakajo, Yuko Mataki, Shoji Natsugoe, Shinichiro Mori, Kosei Maemura, Naotomo Higo, Masahiko Sakoda |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Anastomosis Pancreaticoduodenectomy Pancreatic Fistula Blood loss medicine Humans Pancreas Aged Aged 80 and over Gastrostomy Pancreatic duct business.industry Anastomosis Surgical Perioperative Middle Aged medicine.disease Surgery medicine.anatomical_structure Pancreatic fistula Female Radiology business Duct (anatomy) Pancreatic stump |
| Zdroj: | European Surgical Research. 55:109-118 |
| ISSN: | 1421-9921 0014-312X |
| DOI: | 10.1159/000433425 |
| Popis: | Background/Purpose: This study aimed to evaluate the feasibility and safety of a novel pancreaticogastrostomy technique for diminishing pancreatic fistulas after pancreaticoduodenectomy using gastric wrapping of the pancreatic stump with a twin square-shaped horizontal mattress and a suture fixing the main pancreatic duct to the gastric mucosa anastomosis [twin square wrapping (TSW) method]. Methods: Fifty-three patients undergoing pancreaticogastrostomy after pancreaticoduodenectomy were included in the study and chronologically divided into a conventional group (n = 32) and a TSW group (n = 21). The perioperative factors and the postoperative outcomes were retrospectively analyzed. Results: The operating time for the pancreatic anastomosis, the total operating time, and the blood loss volume in the TSW group were lower than in the conventional group, but without a statistically significant difference. The TSW group had a significantly lower postoperative white blood cell count and C-reactive protein level, with a reduced intra-abdominal fluid accumulation as assessed by computed tomography on postoperative day 7, had a lower incidence of postoperative complications and pancreatic fistulas, and achieved a shorter duration of drain placement and shorter postoperative hospital stays as compared to the conventional group. Conclusions: The TSW technique should be considered for reducing pancreatic fistulas by diminishing the postoperative inflammatory response and improving patient outcomes without increasing the operating time. |
| Databáze: | OpenAIRE |
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