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World Journal of Surgery
Published in: World Journal of Surgery 11/2006

01-11-2006

Effect of Jejunal and Biliary Decompression on Postoperative Complications and Pancreatic Leakage Arising from Pancreatojejunostomy after Pancreatoduodenectomy

Authors: Yoichi Ishizaki, MD, Jiro Yoshimoto, MD, Hiroyuki Sugo, MD, Ken Miwa, MD, Seiji Kawasaki, MD

Published in: World Journal of Surgery | Issue 11/2006

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Abstract

Background

Since its introduction, reconstruction after pancreatoduodenectomy has undergone numerous modifications, leading to a dramatic decline in the mortality rate. However, the reported morbidity rate, due mainly to pancreatic leakage, still remains high.

Methods

Between January 1999 and April 2005, 102 consecutive patients underwent pancreatojejunostomy after pancreatoduodenectomy. Patients treated by biliary decompression alone (n = 58) were compared with patients treated by jejunal decompression alone (n = 40). Four patients who underwent both biliary and jejunal decompression were excluded from the study.

Results

Patients who underwent jejunal decompression had a significantly lower incidence of overall postoperative complications (P = 0.028), pancreatic leakage (P = 0.009), and infection (P = 0.011) than patients who underwent biliary decompression. Only one patient who underwent biliary decompression died as a direct result of pancreatic leakage.

Conclusions

Discontinuation of biliary decompression with postoperative jejunal decompression using tube jejunostomy may be a good option in patients undergoing pancreatoduodenectomy, because it appears to reduce the incidence of overall postoperative complications, pancreatic leakage, and infection.
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Metadata
Title
Effect of Jejunal and Biliary Decompression on Postoperative Complications and Pancreatic Leakage Arising from Pancreatojejunostomy after Pancreatoduodenectomy
Authors
Yoichi Ishizaki, MD
Jiro Yoshimoto, MD
Hiroyuki Sugo, MD
Ken Miwa, MD
Seiji Kawasaki, MD
Publication date
01-11-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 11/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0475-1

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