Pancreaticojejunostomy of duct to mucosa anastomosis can be performed more safely without than with a stenting tube

Am J Surg. 2009 Jul;198(1):51-4. doi: 10.1016/j.amjsurg.2008.05.008. Epub 2009 Feb 13.

Abstract

Background: The aim of this study was to evaluate the safety of performing a pancreaticojejunostomy with a duct-to-mucosa anastomosis without a stenting tube.

Methods: One hundred twenty-one patients with pancreaticojejunostomy, classified into 2 groups of those with duct-to-mucosa anastomoses with stenting tubes (group A; n = 49) and without stenting tubes (group B; n = 72), were investigated. Outcomes, including complications and survival rates, are reported.

Results: In group A, morbidity was 32.7%, 6.7% had pancreatic fistulas, 14.3% had delayed gastric emptying, 6.1% had remnant pancreatitis, 2% had intra-abdominal abscesses, 2% had intra-abdominal bleeding, and mortality was 2%. In group B, morbidity (15.3%) and delayed gastric emptying (2.8%) showed significant differences from group A. Other results were nonsignificant. In the normal soft pancreas, pancreatic fistulas in group B (3.3%) were less frequent than in group A (12.5%).

Conclusion: Pancreaticojejunostomy of a duct-to-mucosa anastomosis could be performed more safely without than with a stenting tube to obtain a definitive anastomosis and transection of the pancreas.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Mucosa / pathology
  • Intestinal Mucosa / surgery
  • Japan / epidemiology
  • Jejunum / pathology
  • Jejunum / surgery*
  • Male
  • Middle Aged
  • Morbidity / trends
  • Pancreatic Diseases / surgery*
  • Pancreatic Ducts / pathology
  • Pancreatic Ducts / surgery*
  • Pancreaticojejunostomy / methods*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Stents*
  • Survival Rate / trends
  • Treatment Outcome