The article represents results of the study held by the personnel of the National Institute of Surgery and Transplantology after A.A. Shalimov and National Institute of Cancer, with a total of 35 pancreatoduodenectomies performed, followed by reconstruction pancreatogastrostomy. Key advantages of the pancreatogastrostomy method from both anatomical-physiological and surgical difficulty views are described in the article. Aims: To analyze the pancreatogastrostomy efficiency as reconstruction stage by assessment of its technical aspects and postoperative complication incidence analysis.

Correlations between CY status and clinicopathological data with overall survival (OS) were analyzed. Results: Twenty-nine patients (8.1%) had positive CY (CY+) and 328 patients had negative CY (CY-). There were significant correlations between CY + and pancreatic body and tail cancer (p = 0.014), tumor extended beyond the pancreas (p = 0.023) and lymph node metastasis (p = 0.003). R0 resection rate was significantly lower in CY + group (p = 0.027). OS of CY + patients was worse than that of CY-patients (median survival time [MST], 16 vs 25 months; p = 0.003), though multivariate analysis of all patients who underwent resection did not identify CY+ as an independent prognostic factor. In CY + group, NCCN resectability status and pre-operative CA19-9 level did not have an impact on OS, however, lower SUVmax was significantly correlated with a better survival (MST, SUVmax < 4.5 vs !4.5, 35 vs 13 months; p = 0.022). Conclusion: Although the survival of patients with resected CY + PDAC is worse than that of patients with resected CY-PDAC, it is suggested that CY + patients with lower SUVmax might have better prognosis.