Morbidity and mortality associated with pancreatogastrostomy and pancreatojejunostomy following partial pancreatoduodenectomy

Abstract

Pancreatogastrostomy is a safe and reliable method of reconstruction after PPD that may be associated with a lower leakage and mortality rate than pancreatojejunostomy.

Strategy to Treat Pancreatic Fistula Using Comprehensive Endoscopic Procedures Together with Percutaneous Methods

“…The disruption of the anastomotic site is the cause of PF and is associated with stricture or occlusion of the anastomosis at early stages after PD. In contrast, the frequency of ARP is low with the ratio of 2% in pancreatogastrostomy [1], and 1.6% [1] to 2.2% [2] in pancreatojejunostomy. The strictured or occluded anastomosis at the late stage post-PD causes ARP [3].…”

“…The frequency of PF is low in patients with pancreatogastrostomy, with a rate of 0-12% [1], while it is more frequent among pancreatojejunostomy patients, with a rate of 10 to 20% [1]. Another study has reported that 14% of patients with pancreatoduodenectomy have suffered from PF [2].…”

Pancreatic Anastomosis Disruption Seven Years Post Pancreaticoduodenectomy

“…Several techniques have been described, and these include duct-to-mucosa pancreaticojejunostomy (PJ), endto-end anastomosis with invagination of the pancreatic stump in a loop of jejunum, pancreaticogastrostomy (PG) with end-to-side and end-to-end anastomosis with invagination. Many studies showed a decreased leak rate with PG [22,23] than with PJ. In contrast, Yeo et al [5] showed that there is no difference in pancreatic leak rate following both PJ and PG.…”

Analysis of procedure-related complications after pancreatodoudenectomy

“…PD nowadays represents a complex procedure and a challenge for the surgeon. Recently, the operative mortality rate after PD has significantly declined, while the incidence of postoperative morbidity remains high, from 40%-50% [1][2][3][4][5][6], and a recent series of 650 operations demonstrated a 30-day mortality of 1.4% [7]. The improved mortality is related to improve general management surgeon expertise and higher volume of procedures being performed in a hospital [5].…”