Roux-en-Y pancreaticojejunostomy reconstruction after deep enucleation of benign or borderline pancreatic lesions: a single-institution experience

HPB (Oxford). 2016 Feb;18(2):145-152. doi: 10.1016/j.hpb.2015.08.007. Epub 2015 Nov 17.

Abstract

Background: Standard pancreatectomy for benign and borderline pancreatic lesions involves resecting a substantial amount of normal pancreatic parenchyma and leads to a subsequent impairment of both exocrine and endocrine pancreatic functions. A limited resection such as enucleation is the preferred option for such neoplasms. However, enucleation is associated with a high risk of postoperative complications in some cases. This study evaluated the feasibility and outcomes of performing deep enucleation with Roux-en-Y pancreaticojejunostomy reconstruction.

Methods: This study included patients who underwent pancreatic lesion enucleation from February 2010 to April 2014 in our hospital. The clinical data were collected and retrospectively analyzed.

Results: This study examined 53 patients who underwent enucleation, 33 of the procedures included deep enucleation with Roux-en-Y pancreaticojejunostomy reconstruction. There was no mortality, and the morbidity rate was 66.7% in this group. No patients developed grade C pancreatic fistulas in both group. None of the patients developed tumor recurrence or exocrine or endocrine insufficiency at a median follow-up of 25 months.

Discussion: Enucleation with Roux-en-Y pancreaticojejunostomy reconstruction is a safe and feasible procedure for the treatment of benign and borderline pancreatic neoplasms adjacent to the common pancreatic duct. This procedure can effectively mitigate the limitations of simple enucleation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Roux-en-Y* / adverse effects
  • China
  • Cholangiopancreatography, Magnetic Resonance
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatectomy* / adverse effects
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Pancreaticojejunostomy* / adverse effects
  • Plastic Surgery Procedures* / adverse effects
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome