Abstract

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

Amin Bahreini*, Amir Ahmad Salmasi, Amir Mardani

Abstract

BACKGROUND: Anastomotic leakage at the pancreaticojejunostomyremains a common complication after pancreaticoduodenectomy.Postoperative pancreatic Fistula (POPF), due to anastomotic leakage, isoften associated with significant morbidity and mortality. The aim ofthis study was to improve a duct to mucosa pancreaticojejunostomy inorder to reduce the anastomotic leakage rate. Methods: Between April2014 and March 2015, 39 patients with periampullary cancers orcancer of pancreatic head who underwent Whipple surgery and ductto-mucosa pancreaticojejunostomy technique were evaluated with adrain amylase and blood amylase at the same time. Intraoperativebleeding, operation time, age, sex and other short-term and long-termcomplications were reviewed. Results: Anastomotic leakage at thepancreaticojejunostomy occurred in 7 patients (17.9%), 6 males and one female. The mean ofintraoperative 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 onPancreatic Fistula (ISGPF) classification. Conclusions: The duct-to-mucosapancreaticojejunostomy technique appears to be one of the safest techniques reported to date.The modifications evaluated in our study can easily be adopted by experienced surgeonsalready performed other techniques of duct-to-mucosa anastomosis.

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