Modified Blumgart anastomosis with the “complete packing method” reduces the incidence of pancreatic fistula and complications after resection of the head of the pancreas

Kojima, Toru; Niguma, Takefumi; Watanabe, Nozomi; Sakata, Taizo; Mimura, Tetsushige

doi:10.1016/j.amjsurg.2018.03.024

Cited by 26 publications

(48 citation statements)

References 37 publications

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“…To prevent clinical POPF, pancreato-biliary surgeons have tried various methods and reported their treatment results, including pancreaticoenterostomy [18,19,28,[33][34][35][36], the use of the pancreatic duct stenting [20][21][22], the management of the drainage tube [37][38][39] and somatostatin analogs [40][41][42]. However, the e cacy of these methods is still controversial.…”

Section: Discussionmentioning

confidence: 99%

Anastomosis Technique For Pancreatojejunostomy And Early Removal Of Drainage Tubes May Reduce Postoperative Pancreatic Fistula

Kawaida

Kono

Amemiya

et al. 2020

Preprint

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Background: Postoperative pancreatic fistula (POPF) is one of the most serious complications after pancreaticoduodenectomy (PD). Various factors have been reported as POPF risks, but the most serious of these is soft pancreas. To reduce POPF occurrences, many changes to the PD process have been proposed. This study evaluates short-term results of anastomosis technique for PD.Methods: In total, 120 patients with soft pancreases who had undergone PD at Yamanashi University between January 2012 and December 2019 were retrospectively analyzed. We divided these patients into two groups depending on the time PD was performed: a conventional group (n=67) and a modified group (n = 53).Results: The rate of clinically relevant POPF was significantly lower in the modified group than that in the conventional group (1.9% vs 22.4%, p < 0.001), with there being only one case of POPF in the modified group. There were no cases of POPF-related hemorrhaging in the modified group. On the third day after the operation, the amylase levels in the drainage fluid for the modified group had reduced to one third of those in the conventional group (1696 vs 643 U/L). Multivariate analysis showed that the modified method was the independent predictors to prevent clinical POPF (p = 0.004).Conclusions: Our novel anastomosis technique for pancreatojejunostomy reduced POPF in PD, especially in cases where the patient had a soft pancreas.

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Section: Discussionmentioning

confidence: 99%

Anastomosis Technique For Pancreatojejunostomy And Early Removal Of Drainage Tubes May Reduce Postoperative Pancreatic Fistula

Kawaida

Kono

Amemiya

et al. 2020

Preprint

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“…In recent years, a transpancreatic U-suture technique has been devised by Blumgart et al [30]. Because of the simple method and excellent results, this method has been validated by many surgeons [31,32], and several surgeons have tried this modi ed method of novel anastomosis and reported the treatment results [28,[33][34][35][36]. This method prevents the tear of pancreatic parenchyma and the jejunum wall, which could be in close contact with the pancreatic cut surface.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Original Scientific Report Anastomosis technique for pancreatojejunostomy and early removal of drainage tubes may reduce postoperative pancreatic fistula

Kawaida¹,

Kono²,

Amemiya³

et al. 2020

Preprint

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Background Postoperative pancreatic fistula (POPF) is one of the most serious complications after pancreaticoduodenectomy (PD). Various factors have been reported as POPF risks, but the most serious of these is soft pancreas. To reduce POPF occurrences, many changes to the PD process have been proposed. This study evaluates short-term results of anastomosis technique for PD.Methods In total, 120 patients with soft pancreases who had undergone PD at Yamanashi University between January 2012 and December 2019 were analyzed. We divided these patients into two groups: a conventional group (n = 67) and a modified group (n = 53).Results The rate of clinically relevant POPF was significantly lower in the modified group than that in the conventional group (1.9% vs 22.4%, p < 0.001), with there being only one case of POPF in the modified group. There were no cases of POPF-related hemorrhaging in the modified group. On the third day after the operation, the amylase levels in the drainage fluid for the modified group had reduced to one third of those in the conventional group (1696 vs 643 U/L).Conclusions Our novel anastomosis technique for pancreatojejunostomy reduced POPF in PD, especially in cases where the patient had a soft pancreas.

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“…The dressing was removed only after evacuation of the drains. POPF type B and C was noted in 20 out of 103 patients in the Cattell-Warren technique group, 49 out of 170 in the Kakita technique group and only 3 out of 101 in the Blumgart technique group [51].…”

Section: The Blumgart and The Kakita Techniquesmentioning

confidence: 90%

Pancreaticojejunostomy—a review of modern techniques

Grudzińska

Mrowiec

2020

Langenbecks Arch Surg

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Background Pancreaticojejunal anastomosis is one of the most demanding procedures in surgery. Up to now, no technique has been proven to reduce the incidence of POPF when compared to the other methods. Purpose The aim of this review was to provide a concise and illustrated description of the most recent methods of pancreaticojejunostomy. Their development was directly related to the still ongoing search by surgeons for such a technique of anastomosis that would eliminate the problem of POPF. Conclusions Knowledge of various techniques of anastomosis may help the surgeon to find the most suitable and optimal method of pancreatic-intestinal anastomosis for the patient.

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Modified Blumgart anastomosis with the “complete packing method” reduces the incidence of pancreatic fistula and complications after resection of the head of the pancreas

Cited by 26 publications

References 37 publications

Anastomosis Technique For Pancreatojejunostomy And Early Removal Of Drainage Tubes May Reduce Postoperative Pancreatic Fistula

Anastomosis Technique For Pancreatojejunostomy And Early Removal Of Drainage Tubes May Reduce Postoperative Pancreatic Fistula

Original Scientific Report Anastomosis technique for pancreatojejunostomy and early removal of drainage tubes may reduce postoperative pancreatic fistula

Pancreaticojejunostomy—a review of modern techniques

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