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Pancreatico‐jejunostomy decreases post‐operative pancreatic fistula incidence and severity after central pancreatectomy.
- Source :
- ANZ Journal of Surgery; Jan/Feb2018, Vol. 88 Issue 1/2, p77-81, 5p, 2 Charts
- Publication Year :
- 2018
-
Abstract
- Backgrounds: Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post‐operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico‐jejunostomy (PJ) and pancreatico‐gastrostomy (PG). Methods: Fifty‐eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed. The distal pancreatic remnant was either anastomosed to the stomach (44.8%, n = 25) or to a Roux‐en‐Y jejunal loop (55.2%, n = 35) with routine external drainage allowing a systematic search for POPF. POPF severity was classified according to the International Study Group on Pancreatic Fistula (ISGPF) and Clavien‐Dindo classifications. Results: The groups were similar on sex ratio, mean age, ASA score, pancreas texture, operative time and operative blood loss. Mean follow‐up was 36.2 ± 3.9 months. POPF were significantly more frequent after PG (76.9 versus 37.5%, P = 0.003). PG was associated with significantly higher grade of POPF both when graded with ISGPF classification (P = 0.012) and Clavien‐Dindo classification (P = 0.044). There was no significant difference in post‐operative bleeding (0.918) and delayed gastric emptying (0.877) between the two groups. Hospital length of stay was increased after PG (23.6 ± 3.5 days versus 16.5 ± 1.9 days, P = 0.071). There was no significant difference in incidence of long‐term exocrine (3.8 versus 19.2%, P = 0.134) and endocrine (7.7 versus 9.4%, P = 0.575) pancreatic insufficiencies. Conclusion: PG was associated with a significantly higher POPF incidence and severity in CP. We recommend performing PJ especially in older patients to improve CP outcomes. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14451433
- Volume :
- 88
- Issue :
- 1/2
- Database :
- Complementary Index
- Journal :
- ANZ Journal of Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 127766492
- Full Text :
- https://doi.org/10.1111/ans.14049