Evaluation of a New Modification of Pancreaticogastrostomy after Pancreaticoduodenectomy: Anastomosis of the Pancreatic Duct to the Gastric Mucosa with Invagination of the Pancreatic Remnant End into the Posterior Gastric Wall forReport as inadecuate




Evaluation of a New Modification of Pancreaticogastrostomy after Pancreaticoduodenectomy: Anastomosis of the Pancreatic Duct to the Gastric Mucosa with Invagination of the Pancreatic Remnant End into the Posterior Gastric Wall for - Download this document for free, or read online. Document in PDF available to download.

International Journal of Surgical Oncology - Volume 2014 2014, Article ID 490386, 7 pages -

Clinical StudyGeneral Surgery Department, Faculty of Medicine, University of Alexandria, Alexandria 21526, Egypt

Received 17 May 2014; Revised 10 August 2014; Accepted 27 August 2014; Published 16 September 2014

Academic Editor: George H. Sakorafas

Copyright © 2014 Mohamed Mazloum Osman and Walid Abd El Maksoud. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background-Objectives. Postoperative pancreatic fistula POPF remains the main problem after pancreaticoduodenectomy and determines to a large extent the final outcome. We describe a new modification of pancreaticogastrostomy which combines duct to mucosa anastomosis with suturing the pancreatic capsule to posterior gastric wall and then invaginating the pancreatic remnant into the posterior gastric wall. This study was designed to assess the results of this new modification of pancreaticogastrostomy. Methods. The newly modified pancreaticogastrostomy was applied to 37 consecutive patients after pancreaticoduodenectomy for periampullary cancer 64.86% or cancer head of the pancreas 35.14%. Eighteen patients 48.65% had a soft pancreatic remnant, 13 patients 35.14% had firm pancreatic remnant, and 6 patients 16.22% had intermediate texture of pancreatic remnant. Rate of mortality, early postoperative complications, and hospital stay were also reported. Results. Operative mortality was zero and morbidity was 29.73%. Only three patients 8.11% developed pancreatic leaks; they were treated conservatively. Eight patients 16.1% had delayed gastric emptying, one patient 2.70% had minor hemorrhage, one patient 2.70% had biliary leak, and four patients 10.81% had superficial wound infection. Conclusions. The new modified pancreatogastrostomy seems safe and reliable with low rate of POPF. However, further prospective controlled trials are essential to support these results.





Author: Mohamed Mazloum Osman and Walid Abd El Maksoud

Source: https://www.hindawi.com/



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