Comparison of Outcomes in Pancreaticogastrostomy versus Pancreaticojejunostomy in Patients Undergoing Pancreaticoduodenectomy
Journal Title: Journal of Surgery Research and Practice - Year 2021, Vol 2, Issue 1
Abstract
Introduction: The postoperative mortality and morbidity after pancreaticoduodenectomy with pancreaticogastrostomy and pancreaticojejunostomy is controversial. Aim of the study: Primary aim was comparison of Post-Operative Pancreatic Fistula (POPF) rate in PG vs PJ. Secondary aim was mortality rate between PG vs PJ. Method: A retrospective analysis of data of 74 patients who underwent pancreaticoduodenectomy with either pancreaticogastrostomy or pancreaticojejunostomy from June 2012 to June 2014. Statistical analysis done using un-paired ‘t’ test, chi square test, fischer’s exact test appropriately. Result: Out of 74 pancreaticoduodenectomy case. Pancreaticogastrostomy was done in 44(59.5%) cases and pancreaticojejunostomy done in 30(40.5%) of cases. Among them 20(27.16%) patients developed pancreatic fistula of which 9(12.16%) belonged to pancreaticogastrostomy group and 11(15%) belonged to pancreaticojejunostomy group (p=0.708). Grade A fistula occurred in 8(10.8%) patients, grade C fistula in 1(1.35%) patient in the pancreaticogastrostomy compared with grade A fitula in 11(15%) patients in the pancreaticojejunostomy group. Significant post pancreaticoduodenectomy haemorrhage [3 patients (6.8%) (p=0.0001)] and mortality [3 patients(6.8%)] was seen in PG group. No significant difference in median hospital stay was (PG=11.1±2.78 vs PJ= 10.4± 3.1) seen in either group (p=0.305). Conclusion: There was no significant difference in pancreatic fistula rate and hospital stay in either groups. However grade a fistula was more in pancreaticojejunostomy group. Significant mortality was seen in pancreaticogastrostomy group though they were not related to pancreatic fistula.
Authors and Affiliations
Vimalakar Reddy*, Mustafa Hussain Razvi, Bhavya Manosila, Mohan Narasimha, Ramesh Ardhanari
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