178874

A Comparative Study between Duct-to-Mucosa and Invagination Technique for Reconstruction after Pancreaticoduodenectomy: Aprospective Study

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Last updated: 05 Jan 2025

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Abstract

Background: The pancreaticojejunostomy has notoriously been known to carry a high rate of operative complications,morbidity,and mortality mainly due to anastomotic leak and ensuing septic complications. Patients and methods: From January 2012 to October 2015, we presented a prospective study which included 24 patients who underwent pancreaticoduodenectomy (PD) operation through either Whipple resection or modified Whipple(pylorus-preserving).Patients were reviewed and divided into 2 groups (A,B) according to the type of pancreaticojejunostomy (PJ), (invagination vs duct-to-mucosa ). Results: 12 patients in each group were operated on: Group A patients had invagination technique for PJ ,while all the 12 patients in group B had duct –to-mucosa anastomotic technique for PJ. 1 (8.3%)case in group A developed pancreatic fistula (PF),while 3 (25%) cases in group B developed PF, and 1 case (8.3%) in group A had mild anastomotic leak which was managed conservatively,while 3 cases (25%) in group B developed moderate to severe anastomotic leak with intra-abdominal collection which required CT-guided percutaneous drainage and operative intervention. Average age was (mean ±SD) = (55 ±12),average operative time was (245 ±75) min. Conclusion: PF after PD represents a critical trigger of potentially life-threatening complications. Although the best method for dealing with the pancreatic stump after PD remains controversial, recent reports described the invagination technique todecrease the rate of PF significantly compared to the duct-to-mucosa technique. Our results appeared to be closely related to the published literature.

DOI

10.21608/asjs.2016.178874

Keywords

Pancreatic fistula (PF), pancreaticodudenectomy (PD), pancreaticojejunostomy (PJ), invagination technique, duct-to-mucosa technique

Authors

First Name

Mohamed

Last Name

El Serafe

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Affiliation

Department of General Surgery , Ain Shams University, Cairo, Egypt.

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First Name

Ahmed Hussein

Last Name

Abd El hafiz

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Affiliation

Department of General Surgery , Ain Shams University, Cairo, Egypt.

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First Name

Mohamed Shaaban

Last Name

Khalifa

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-

Affiliation

Department of General Surgery , Ain Shams University, Cairo, Egypt.

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Volume

9

Article Issue

2

Related Issue

25660

Issue Date

2016-07-01

Receive Date

2021-06-21

Publish Date

2016-07-01

Page Start

161

Page End

168

Print ISSN

2090-7249

Online ISSN

3009-7509

Link

https://asjs.journals.ekb.eg/article_178874.html

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https://asjs.journals.ekb.eg/service?article_code=178874

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3

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Original Article

Type Code

1,943

Publication Type

Journal

Publication Title

Ain Shams Journal of Surgery

Publication Link

https://asjs.journals.ekb.eg/

MainTitle

A Comparative Study between Duct-to-Mucosa and Invagination Technique for Reconstruction after Pancreaticoduodenectomy: Aprospective Study

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Article

Created At

23 Jan 2023