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- Title
Pancreaticogastrostomy after Pancreaticoduodenectomy Using Twin Square Wrapping with Duct-to-Mucosa Anastomosis.
- Authors
Maemura, Kosei; Mataki, Yuko; Kurahara, Hiroshi; Mori, Shinichiro; Higo, Naotomo; Sakoda, Masahiko; Iino, Satoshi; Nakajo, akihiro; Ishigami, Sumiya; Ueno, Shinichi; Takao, Sonshin; Shinchi, Hiroyuki; Natsugoe, Shoji
- Abstract
Background/Purpose: This study aimed to evaluate the feasibility and safety of a novel pancreaticogastrostomy technique for diminishing pancreatic fistulas after pancreaticoduodenectomy using gastric wrapping of the pancreatic stump with a twin square-shaped horizontal mattress and a suture fixing the main pancreatic duct to the gastric mucosa anastomosis [twin square wrapping (TSW) method]. Methods: Fifty-three patients undergoing pancreaticogastrostomy after pancreaticoduodenectomy were included in the study and chronologically divided into a conventional group (n = 32) and a TSW group (n = 21). The perioperative factors and the postoperative outcomes were retrospectively analyzed. Results: The operating time for the pancreatic anastomosis, the total operating time, and the blood loss volume in the TSW group were lower than in the conventional group, but without a statistically significant difference. The TSW group had a significantly lower postoperative white blood cell count and C-reactive protein level, with a reduced intra-abdominal fluid accumulation as assessed by computed tomography on postoperative day 7, had a lower incidence of postoperative complications and pancreatic fistulas, and achieved a shorter duration of drain placement and shorter postoperative hospital stays as compared to the conventional group. Conclusions: The TSW technique should be considered for reducing pancreatic fistulas by diminishing the postoperative inflammatory response and improving patient outcomes without increasing the operating time. © 2015 S. Karger AG, Basel
- Subjects
PANCREATICODUODENECTOMY; PANCREATIC diseases; MUCOUS membrane diseases; POSTOPERATIVE care; DUODENECTOMY; THERAPEUTICS
- Publication
European Surgical Research, 2015, Vol 55, Issue 1/2, p109
- ISSN
0014-312X
- Publication type
Article
- DOI
10.1159/000433425