Central pancreatectomy: Comparison of results according to the type of anastomosis

Venara, Aurélien; Franco, Valéria De; Mucci, S.; Frampas, É.; Lermite, Émilie; Régenet, Nicolas; Hamy, A.

doi:10.1016/j.jviscsurg.2012.01.002

Cited by 13 publications

(22 citation statements)

References 15 publications

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“…A retrospective study was performed with four French referral centres from January 1988 to December 2011. Twenty‐five patients from Nantes and Angers were the population analysed in an initial study from Venara et al . In order to empower the study, we included patients from University Hospitals of La Timone (Marseille) and Rennes.…”

Section: Methodsmentioning

confidence: 99%

“…This study was powered as a superiority trial; the design based on the previous results from Venara et al . The null hypothesis was that PJ and PG were associated with similar POPF rates after CP.…”

Section: Methodsmentioning

confidence: 99%

“…The alternative hypothesis was that PJ was superior to PG with regard to POPF incidence reduction. POPF rates were, respectively, taken to be 20% in PJ group and 70% in the PG group considering the previous results of 18.1 and 71.4% . Group sample sizes were taken to be 19 in each group to detect a significant difference between the groups with a significant level of 0.05 and a 90% power.…”

Section: Methodsmentioning

confidence: 99%

“…In a previous study, Venara et al . showed that pancreatico‐gastrostomy (PG) was associated with a significantly higher POPF rate than pancreatico‐jejunostomy (PJ) after CP, but failed to show a clinically relevant difference in severity of outcomes between the two techniques …”

Section: Introductionmentioning

confidence: 99%

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Pancreatico‐jejunostomy decreases post‐operative pancreatic fistula incidence and severity after central pancreatectomy

Borel

Ouaïssi²,

Merdrignac

et al. 2017

ANZ Journal of Surgery

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Backgrounds: Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreaticogastrostomy (PG). Methods: Fifty-eight patients (mean age 53.9 AE 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed. The distal pancreatic remnant was either anastomosed to the stomach (44.8%, n = 25) or to a Roux-en-Y jejunal loop (55.2%, n = 35) with routine external drainage allowing a systematic search for POPF. POPF severity was classified according to the International Study Group on Pancreatic Fistula (ISGPF) and Clavien-Dindo classifications. Results: The groups were similar on sex ratio, mean age, ASA score, pancreas texture, operative time and operative blood loss. Mean follow-up was 36.2 AE 3.9 months. POPF were significantly more frequent after PG (76.9 versus 37.5%, P = 0.003). PG was associated with significantly higher grade of POPF both when graded with ISGPF classification (P = 0.012) and Clavien-Dindo classification (P = 0.044). There was no significant difference in postoperative bleeding (0.918) and delayed gastric emptying (0.877) between the two groups. Hospital length of stay was increased after PG (23.6 AE 3.5 days versus 16.5 AE 1.9 days, P = 0.071). There was no significant difference in incidence of long-term exocrine (3.8 versus 19.2%, P = 0.134) and endocrine (7.7 versus 9.4%, P = 0.575) pancreatic insufficiencies. Conclusion: PG was associated with a significantly higher POPF incidence and severity in CP. We recommend performing PJ especially in older patients to improve CP outcomes.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pancreatico‐jejunostomy decreases post‐operative pancreatic fistula incidence and severity after central pancreatectomy

Borel

Ouaïssi²,

Merdrignac

et al. 2017

ANZ Journal of Surgery

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show abstract

“…Reported POPF rates range from 7.7% to 63%, 26,34,35 but on average most studies report a rate of about 30% to 40%. 29,32,36,37 The discrepancy in reported rates is probably due to differences in definitions and assessment methods. In our experience, the systematic prospective drain fluid amylase assay could explain the high rate of pancreatic fistula at least in part.…”

Section: Discussionmentioning

confidence: 99%

Reappraisal of Central Pancreatectomy

et al. 2014

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Limited Surgery for Benign Tumours of the Pancreas: A Systematic Review

et al. 2015

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EN, CP and DPPHRt/p applied for benign tumours are associated with low surgery-related early postoperative morbidity, a very low hospital mortality and the advantages of conservation of pancreatic functions. However, the level of evidence for EN and CP compared to standard oncological resections appears presently low. There is a high level of evidence from prospective controlled trials regarding the significant maintenance of exocrine and endocrine pancreatic functions after DPPHRt/p compared to pancreato-duodenectomy.

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Central pancreatectomy: Comparison of results according to the type of anastomosis

Abstract: This work showed a less important incidence of low-grade fistula after pancreatico-jejunal anastomosis in the fall of a PM. This result should be confirmed by a later study on a more important sample of PM.

Cited by 13 publications

References 15 publications

Pancreatico‐jejunostomy decreases post‐operative pancreatic fistula incidence and severity after central pancreatectomy

Pancreatico‐jejunostomy decreases post‐operative pancreatic fistula incidence and severity after central pancreatectomy

Reappraisal of Central Pancreatectomy

Limited Surgery for Benign Tumours of the Pancreas: A Systematic Review

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