Extramucosal Pancreaticojejunostomy: Early Outcomes of an Easy Technique for a Challenging Stage of Pancreaticoduodenectomy
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 10
Abstract
Pancreatojejunostomy anastomosis is the most clinically important step of pancreaticoduodenectomy procedures. In this study we present the outcomes of an easy technique for patients who underwent pancreaticoduodenectomy. Patients who underwent pancreaticoduodenectomy with extra mucosal pancreatojejunostomy were evaluated retrospectively. Patients who underwent laparoscopic pancreaticoduodenectomy or emergency surgery, who were operated for reasons unrelated to cancer, and whose pancreatojejunostomy anastomosis were done using techniques other than the extramucosal technique were excluded from the study. The patients were evaluated in terms of age, gender, American Society of Anesthesiologists (ASA) operative risk score, body mass index (BMI), comorbid diseases, histopathological diagnosis, operative time, and intraoperative blood loss, length of hospital stay, and postoperative morbidity and mortality. The 17 patients operated with extra mucosal pancreatojejunostomy technique were included in the study. Nine of the patients were male, 8 were female and the mean age was 68.2±13.1 (range 36-85) years. Mean BMI was 25.3±2.7 kg/m2 (range 22-30). Mean operative time was 281.1±54.2 minutes. Mean length of hospital stay was 16.4±7.3 (range 7-37) days and mean follow-up time was 15.7±4.3 months. Six patients (35%) developed postoperative complications. Three (18%) developed postoperative pancreatic fistula, 2 of which were classified as ISGPF grade A and the other as grade C. Postoperative mortality rate was 6% (n=1). Overall, the 1-year survival rate was 59%. The extra mucosal pancreatojejunostomy anastomosis technique can be safely and successfully used in pancreaticoduodenectomy procedures as a standard method independent of pancreatic tissue and duct features.
Authors and Affiliations
Servet Karagul, Oktay Karakose
Keywords
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