Comparative study between invagination and duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy

Abstract

Background; Pancreaticoduodenectomy (PD) is the commonest utilized standard surgery for both malignant and benign disorders in the pancreatic head. After the resection, pancreaticojejunostomy (PJ) is taken in to consideration as the most vital and problematic method. Methods; this prospective randomized controlled study had been performed in surgery department El Minia University and El Maadi military hospital including 80 patients in 2 groups indicated for PD (40 cases with duct to mucosa PJ (group 1) and 40 cases with invaginations PJ (group 2)) in the period between January 2018 and January 2021 after acceptance from the IRB and obtaining informed agreement from all cases including approval of protocol of treatment. Result; Nonsignificant changes among the study groups regarding the median hospitalization time, the median time to resume oral intakes and drain elimination. POPF happened in 9 (22.5%) cases in group 1 and 15(37.5%) cases in group 2. The POPF severity was detected more in group 1 with nonsignificant variances (Table 3). The in hospital mortalities in this work was 11 (13.75%) cases (8 (20%) cases in group 1 vs. 3 (7.5%) cases in group 2, Conclusion; Duct-to-mucosa method for anastomosis must possibly be the 1st choice. However, among cases who possess too small pancreatic duct, invaginations are mostly the securer and easier to perform procedure. Increased incidence of postoperative pancreatitis, steatorrhea and DM is observed in duct to mucosa PJ.