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Abstract

THE EVALUATION OF DUCT-TO-MUCOSAL PANCREATICOJEJUNOSTOMY LEAKAGE IN PANCREATICODUODENECTOMY

Amin Bahreini*, Amir Ahmad Salmasi, Amir Mardani

ABSTRACT

BACKGROUND: Anastomotic leakage at the pancreaticojejunostomy
remains a common complication after pancreaticoduodenectomy.
Postoperative pancreatic Fistula (POPF), due to anastomotic leakage, is
often associated with significant morbidity and mortality. The aim of
this study was to improve a duct to mucosa pancreaticojejunostomy in
order to reduce the anastomotic leakage rate. Methods: Between April
2014 and March 2015, 39 patients with periampullary cancers or
cancer of pancreatic head who underwent Whipple surgery and ductto-
mucosa pancreaticojejunostomy technique were evaluated with a
drain amylase and blood amylase at the same time. Intraoperative
bleeding, operation time, age, sex and other short-term and long-term
complications were reviewed. Results: Anastomotic leakage at the
pancreaticojejunostomy occurred in 7 patients (17.9%), 6 males and one female. The mean of
intraoperative bleeding was 535.90 ml and the mean of operation time was 270.51 minutes.
All POPFs in the study group in grade A according to International Study Group on
Pancreatic Fistula (ISGPF) classification. Conclusions: The duct-to-mucosa
pancreaticojejunostomy technique appears to be one of the safest techniques reported to date.
The modifications evaluated in our study can easily be adopted by experienced surgeons
already performed other techniques of duct-to-mucosa anastomosis.

Keywords: duct-to-mucosa Pancreaticojejunostomy; Pancreatic fistula; Pancreaticoduodenectomy.


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