Does modified Blumgart anastomosis without intra-pancreatic ductal stenting reduce post-operative pancreatic fistula after pancreaticojejunostomy?

Autor: Sohei Satoi, Tomohisa Yamamoto, Hiroaki Yanagimoto, So Yamaki, Hisashi Kosaka, Satoshi Hirooka, Masaya Kotsuka, Hironori Ryota, Taku Michiura, Kentaro Inoue, Yoichi Matsui
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Asian Journal of Surgery, Vol 42, Iss 1, Pp 343-349 (2019)
Druh dokumentu: article
ISSN: 1015-9584
DOI: 10.1016/j.asjsur.2018.06.008
Popis: Summary: Background: Post-operative pancreatic fistula (POPF) is one of the most common and serious complications after pancreaticoduodenectomy (PD). The aim of this study is to retrospectively compare clinically relevant (CR) POPF and other complications after pacreaticojejunostomy (PJ) after modified Kakita (m-Kakita) or modified Blumgart (m-Blumgart) anastomoses without stenting in a single institution. Methods: One hundred twenty-eight patients underwent PJ using m-Kakita anastomoses (two interrupted penetrating sutures) between January 2009 and December 2011. One hundred eighteen patients underwent m-Blumgart anastomoses (two transpancreatic/jejunal seromuscular sutures to cover the pancreatic stump with jejunal serosa) between January 2014 and December 2015. Demographics, clinical characteristics, and post-operative mortality and morbidity were retrospectively compared between the two groups. Results: There were no significant differences in demographics or clinical characteristics between the two groups except operative time. A significantly lower rate of CR-POPF was found in the m-Blumgart group relative to the m-Kakita group (10% vs. 19%, p = 0.038). Univariate and multivariate analyses revealed that the m-Blumgart anastomosis and fistula risk category (Negligible, Low) were independently protective against CR-POPF (p
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