Pancreaticogastrostomy Decreased Relaparotomy Caused by Pancreatic Fistula After Pancreaticoduodenectomy Compared With Pancreaticojejunostomy

Oussoultzoglou, Elíe; Bachellier, Philippe; Bigourdan, Jean-Marc; Weber, Jean-Christophe; Nakano, Hiroshi; Jaeck, Daniel

doi:10.1001/archsurg.139.3.327

Cited by 106 publications

(93 citation statements)

References 46 publications

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“…41,42 Currently, a palliative resection for patients with pancreatic carcinoma can be performed safely with low mortality and acceptable morbidity in large-volume centers. 41,43,44 Our results showed that perioperative mortality and morbidity were not different in patients with or without PV resection and similar to the results reported after stent palliation or surgical bypass. 31,43,45 Therefore, pancreatic resection, even in the case of PV wall invasion, could be an alternative for palliative treatment of pancreatic cancer.…”

Section: Commentsupporting

confidence: 88%

Significance of the Depth of Portal Vein Wall Invasion After Curative Resection for Pancreatic Adenocarcinoma

Fukuda

Oussoultzoglou²,

Bachellier³

et al. 2007

Arch Surg

110

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Section: Commentsupporting

confidence: 88%

Significance of the Depth of Portal Vein Wall Invasion After Curative Resection for Pancreatic Adenocarcinoma

Fukuda

Oussoultzoglou²,

Bachellier³

et al. 2007

Arch Surg

110

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“…Overall, 26 articles describing 3,752 patients were identified for the meta-analysis: 22 OCSs (n = 3, 199 patients) [35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56] and 4 RCTs (n = 553 patients) [10,57,58,59]. A total of 1,922 patients underwent PG (RCTs n = 276 patients, OCSs n = 1,646 patients), whilst 1,830 patients underwent PJ (RCTs n = 277 patients, OCSs n = 1,553 patients).…”

Section: Resultsmentioning

confidence: 99%

Pancreaticojejunostomy versus Pancreaticogastrostomy after Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis

He¹,

Zhao

Chen³

et al. 2013

Dig Surg

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Background and Objectives: The method of pancreatic reconstruction after pancreaticoduodenectomy (PD) is closely associated with postoperative morbidity, mortality, and patient's quality of life. The objective of this study is to evaluate which anastomosis approach - pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is a better option of choice in terms of postoperative complications. Methods: Articles comparing PG and PJ that were published by July 2011 were retrieved and subjected to a systematic review and meta-analysis. Results: Four randomized controlled trials (RCTs) and 22 observational clinical studies (OCSs) were included. RCTs showed that the PG group had significantly lower incidence rates of postoperative intra-abdominal fluid collection (p = 0.003, relative risk (RR) 0.50, 95% CI 0.31-0.79) and multiple intra-abdominal complications (p = 0.0007, RR 0.26, 95% CI 0.12-0.56) than the PJ group. OCSs demonstrated significant differences between PG and PJ in terms of frequencies of postoperative biliary fistula, intra-abdominal fluid collection, pancreatic fistula, morbidity, and mortality. The overall analysis revealed significant differences in frequencies of intra-luminal hemorrhage (p = 0.03, OR 2.82, 95% CI 1.08-7.33) and grade B/C pancreatic fistula (p = 0.002, OR 0.42, 95% CI 0.24-0.73) between the two groups. Conclusions: Current literature has no adequate evidence to prove that PG is superior to PJ for patients undergoing PD in terms of postoperative complications. A standardized classification of pancreatic fistula and other intra-abdominal complications may enable an objective, valid comparison between PG and PJ.

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“…Several techniques have been described, and these include duct-to-mucosa pancreaticojejunostomy (PJ), endto-end anastomosis with invagination of the pancreatic stump in a loop of jejunum, pancreaticogastrostomy (PG) with end-to-side and end-to-end anastomosis with invagination. Many studies showed a decreased leak rate with PG [22,23] than with PJ. In contrast, Yeo et al [5] showed that there is no difference in pancreatic leak rate following both PJ and PG.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Anastomosis Disruption Seven Years Post Pancreaticoduodenectomy

Faraj

Zaher

Khalifeh

2010

Journal of Surgical Research

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We are reporting a case of a 22 year-old female patient, who underwent a pancreaticoduodenectomy previously for a solidpseudopapillary neoplasm of the pancreas and was re-admitted seven years later with a pancreatic leak following disruption of the pancreatico-jejunal anastomosis. Exploratory laparotomy revealed a large collection at the level of the pancreatic anastomosis with major disruption of the pancreatico-jejunal anastomosis. The pancreatic stump was refreshed as well as the jejunal site and a duct to mucosa anastomosis was performed. She remains well with a follow up of 18 months.

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Pancreaticogastrostomy Decreased Relaparotomy Caused by Pancreatic Fistula After Pancreaticoduodenectomy Compared With Pancreaticojejunostomy

Cited by 106 publications

References 46 publications

Significance of the Depth of Portal Vein Wall Invasion After Curative Resection for Pancreatic Adenocarcinoma

Significance of the Depth of Portal Vein Wall Invasion After Curative Resection for Pancreatic Adenocarcinoma

Pancreaticojejunostomy versus Pancreaticogastrostomy after Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis

Pancreatic Anastomosis Disruption Seven Years Post Pancreaticoduodenectomy

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