A modified single-loop reconstruction after pancreaticoduodenectomy reduces severity of postoperative pancreatic fistula in high-risk patients

Abstract

The new mSL reconstruction was safer than conventional SL and faster to perform than DL reconstruction in patients with a high-risk pancreas. It did not influence the rate of POPF, but reduced its severity, leading to less major morbidity and mortality.

Facing the surgeon's nightmare: Incidence and management of postoperative pancreatic fistulas grade C after pancreaticoduodenectomy based on the updated definition of the International Study Group of Pancreatic Surgery (ISGPS)

“…Multivariate analyses are demonstrated in Table . Modified single‐loop reconstruction according to Aghalarov et al had no impact on the occurrence of POPF grade C. Intraoperative blood loss (mean 377 ± 248 mL), intraoperative blood transfusions (24 patients, 3.3%), and mean operative time (366 min) were not identified as risk factors. Mean blood loss was 377 ± 248 mL.…”

Comparison of surgical outcomes between isolated pancreaticojejunostomy, isolated gastrojejunostomy, and conventional pancreaticojejunostomy after pancreaticoduodenectomy: a systematic review and meta-analysis

“…Interestingly, isolated pancreaticojejunostomy decreases the incidence of reoperation in this study. The study conducted by Aghalarov et al and Chhaidar et al showed that isolated pancreaticojejunostomy has less reoperation [10,20]. They showed that the reoperation was largely because of POPF-related complications.…”

“…Of these, 420 duplicate articles were excluded, and we retrieved the remaining 1143 studies based on their titles and abstracts. After excluding irrelevant articles for various reasons, we included a final 14 trials involving a total of 2043 patients [6,[9][10][11][12][19][20][21][22][23][24][25][26][27]. A flowchart of the literature search process is shown in Fig.…”

“…However, the debate regarding these three reconstructions is on-going. Some studies demonstrated that isolated pancreaticojejunostomy and isolated gastrojejunostomy may be associated with less postoperative complications, such as POPF [10] and DGE [11]. Kaman et al suggested that morbidity and mortality could be reduced using isolated pancreaticojejunostomy to separate the bile from pancreatic secretions [12]; however, other studies reached different conclusions.…”

Comparison of surgical outcomes between isolated pancreaticojejunostomy, isolated gastrojejunostomy, and conventional pancreaticojejunostomy after pancreaticoduodenectomy: A systematic review and meta-analysis

“…Of these, 420 duplicate articles were excluded, and we retrieved the remaining 1143 studies based on their titles and abstracts. After excluding irrelevant articles for various reasons, we included a nal 14 trials involving a total of 2043 patients [6,[9][10][11][12][19][20][21][22][23][24][25][26][27]. A owchart of the literature search process is shown in Figure 1, and the characteristics and quality evaluation of the included studies are shown in Table 1.…”