Pancreaticogastrostomy after pancreaticoduodenectomy without suturing the pancreas.

Halkic N; Kobayashi K; Kokudo T; Di Mare L; Yamaguchi T; Kudo H; Demartines N; Uldry E

doi:10.1007/s00595-019-01854-1

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Journal article

Pancreaticogastrostomy after pancreaticoduodenectomy without suturing the pancreas.

Halkic N Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Kobayashi K Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Kokudo T Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Di Mare L Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Yamaguchi T Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kudo H Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Demartines N Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Nicolas.Demartines@chuv.ch.
Uldry E Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

2019-07-27

Published in:

Surgery today. - 2020

Sutureless Surgical Procedures

English The aim of the present paper was to describe a new and easy technique for performing pancreaticogastrostomy (PG) through simple pancreatic invagination by a single binding suture without suturing the pancreatic parenchyma. The present study included all consecutive patients who underwent elective pancreaticoduodenectomy from 2007 to 2015. The intraoperative and postoperative outcomes after PG (PG group) were compared with those of patients who underwent pancreaticojejunostomy (PJ) (PJ group). Out of 270 patients, 88 PG and 182 PJ patients were assessed. The rate of clinically significant PF was similar between the PG and PJ groups (10.2% vs. 13.2%, respectively; p = 0.487), despite the risk of pancreatic fistula being higher in the PG group. There were no significant differences in the intraoperative and postoperative outcomes or mortality between the groups. This easy invagination technique for PG is simple, safe and reproducible with a low risk of postoperative pancreatic fistula.

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