Top

Journal of Hepato-Biliary-Pancreatic Sciences

Published in:

01-03-2011 | Original Article

Pancreaticoduodenectomies with a duct-to-mucosa pancreaticojejunostomy anastomosis with and without a stenting tube showed no differences in long-term follow-up

Authors: Shuji Suzuki, Satoshi Kaji, Nobusada Koike, Nobuhiko Harada, Tsuneo Hayashi, Mamoru Suzuki, Toshihide Imaizumi, Fujio Hanyu

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 2/2011

Abstract

Background/purpose

The aim of this study was to evaluate the long-term complications of pancreaticoduodenectomy with a duct-to-mucosa pancreaticojejunostomy anastomosis without a stenting tube.

Methods

Patients were followed for at least 3 years after pancreaticoduodenectomy. They were classified into two groups: duct-to-mucosa pancreaticojejunostomy anastomosis with a stenting tube (group A: 24) and without a stenting tube (group B: 21). Outcomes, including complications and dilatation of the pancreatic duct, were reported retrospectively.

Results

The following complication rates were found for group A: morbidity 29.1%, cholangitis 12.5%, nonalcoholic steatohepatitis 4.2%, liver abscess 4.2%, intrahepatic stones 4.2%, abnormal glucose tolerance (progression of diabetes) 20.8%, and dilatation of the pancreatic duct 20.8%. In group B, the rates for morbidity (14.3%) and abnormal glucose tolerance (19%), and dilatation of the pancreatic duct (4.8%) were lower than those in group A, but all results lacked statistical significance.

Conclusions

Pancreaticoduodenectomy with a duct-to-mucosa anastomosis of pancreaticojejunostomy with or without a stenting tube showed no difference in long-term follow-up.

Butturini G, Daskalaki D, Molinari E, Scopelliti F, Casarotto A, Bassi C. Pancreatic fistula: definition and current problems. J Hepatobiliary Pancreat Surg. 2008;15:247–51.PubMedCrossRef

Yeo CJ, Cameron JL, Maher MM, Sauter PK, Zahurak ML, Talamini MA, et al. A prospective trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg. 1995;222:580–92.PubMed

Balcom JH 4th, Rattner DW, Warshaw AL, Chang Y, Fernandez-del Castillo C. Ten-year experience with 733 pancreatic resections. Changing indications, older patients, and decreasing length of hospitalization. Arch Surg. 2001;136:391–8.PubMedCrossRef

Butturini G, Marcucci S, Morinari E, Mascetta G, Landoni L, Crippa S, et al. Complications after pancreaticoduodenectomy: the problem of current definitions. J Hepatobiliary Pancreat Surg. 2006;13:207–11.PubMedCrossRef

Trede M, Saeger HD, Schwall G, Rumstadt B. Resection of pancreatic cancer: surgical achievements. Langenbecks Arch Surg. 1998;383:121–8.PubMed

Yeo CJ, Cameron JL, Sohn TA, Lillemoe KD, Pitt HA, Talamini MA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg. 1997;226:248–57.PubMedCrossRef

Klinkenbijl JH, van der Schelling GP, Hop WC, van Pel R, Bruining HA, Jeekel J. The advantages of pylorus-preserving pancreatoduodenectomy in malignant disease of the pancreas and periampullary region. Ann Surg. 1992;216:142–5.PubMedCrossRef

Yeo CJ, Cameron JL, Maher MM, Hruban RH, Lillemoe KD, Pitt HA. Periampullary adenocarcinoma: analysis of 5-year survivors. Ann Surg. 1998;227:821–31.PubMedCrossRef

Jimenez RE, Fernandez-del Castillo C, Rattner DW, Chang Y, Warshaw AL. Outcome of pancreaticoduodenectomy with pylorus preservation or with antrectomy in the treatment of chronic pancreatitis. Ann Surg. 2000;231:293–300.PubMedCrossRef

10.

Ohtsuka T, Yamaguchi K, Chijiiwa K, Kinukawa N, Tanaka M. Quality of life after pylorus-preserving pancreatoduodenectomy. Am J Surg. 2001;182:230–6.PubMedCrossRef

11.

Imaizumi T, Hatori T, Tobita K, Fukuda A, Takasaki K, Makuuchi H. Pancreaticojejunostomy using duct-to-mucosa anastomosis without a stenting tube. J Hepatobiliary Pancreat Surg. 2006;13:194–201.PubMedCrossRef

12.

Suzuki S, Kaji S, Koike N, Harada N, Tanaka S, Hayashi T, et al. Pancreaticojejunostomy using duct to mucosa anastomosis can be performed more safely without than with a stenting tube. Am J Surg. 2009;198:51–4.PubMedCrossRef

13.

Tani M, Kawai M, Hirono S, Ina S, Miyazawa M, Nishioka R, et al. A pancreaticoduodenectomy is acceptable for periampullary tumors in the elderly, even in patients over 80 years of age. J Hepatobiliary Pancreat Surg. 2009;16:675–80.PubMedCrossRef

14.

Buchler MW, Friess H, Wagner M, Kulli C, Wagener V, Z’Graggen K. Pancreatic fistula after pancreatic head resection. Br J Surg. 2000;87:883–9.PubMedCrossRef

15.

Adham M, Jaeck D, Le Borgne J, Oussoultzouglou E, Chenard-Neu MP, Mosnier JF, et al. Long-term survival (5–20 years) after pancreatectomy for pancreatic ductal adenocarcinoma: a series of 30 patients collected from 3 institutions. Pancreas. 2008;37:352–7.PubMedCrossRef

16.

Han SS, Kim SW, Jang JY, Park YH. A comparison of the long-term functional outcomes of standard pancreatoduodenectomy and pylorus-preserving pancreatoduodenectomy. Hepatogastroenterology. 2007;54:1831–5.PubMed

17.

Shyr YM, Chen TH, Su CH, Wu CW, Lui WY. Non-stented pancreaticogastrostomy for 111 patients undergoing pylorus-preserving pancreaticoduodenectomy. Hepatogastroenterology. 2005;52:253–7.PubMed

18.

Imaizumi T, Harada N, Hatori T, Fukuda A, Takasaki K. Stenting is unnecessary in duct-to-mucosa pancreaticojejunostomy even in the normal pancreas. Pancreatology. 2002;2:116–21.PubMedCrossRef

19.

Fujino Y, Suzuki Y, Matsumoto I, Sakai T, Ajiki T, Ueda T, et al. Long-term assessments after pancreaticoduodenectomy with pancreatic duct invagination anastomosis. Surg Today. 2007;37:860–6.PubMedCrossRef

20.

Ishikawa O, Ohigashi H, Eguchi H, Yokoyama S, Yamada T, Takachi K, et al. Long-term follow-up of glucose tolerance function after pancreaticoduodenectomy: comparison between pancreaticogastrostomy and pancreaticojejunostomy. Surgery. 2004;136:617–23.PubMedCrossRef

21.

Jang JY, Kim SW, Han JK, Park SJ, Park YC, Joon Ahn Y, et al. Randomized prospective trial of the effect of induced hypergastrinemia on the prevention of pancreatic atrophy after pancreatoduodenectomy in humans. Ann Surg. 2003;237:522–9.PubMedCrossRef

22.

Ahn YJ, Kim SW, Park YC, Jang JY, Yoon YS, Park YH, et al. Duodenal-preserving resection of the head of the pancreas and pancreatic head resection with second-portion duodenectomy for benign lesions, low-grade malignancies, and early carcinoma involving the periampullary region. Arch Surg. 2003;138:162–8. (discussion 168).PubMedCrossRef

Title: Pancreaticoduodenectomies with a duct-to-mucosa pancreaticojejunostomy anastomosis with and without a stenting tube showed no differences in long-term follow-up
Authors: Shuji Suzuki
Satoshi Kaji
Nobusada Koike
Nobuhiko Harada
Tsuneo Hayashi
Mamoru Suzuki
Toshihide Imaizumi
Fujio Hanyu
Publication date: 01-03-2011
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 2/2011
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-010-0339-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Pancreaticoduodenectomies with a duct-to-mucosa pancreaticojejunostomy anastomosis with and without a stenting tube showed no differences in long-term follow-up

Abstract

Background/purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background/purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2011

Body surface area index predicts outcome in orthotopic liver transplantation

Endoscopic ultrasonography-guided gallbladder drainage: actual technical presentations and review of the literature (with videos)

Allopurinol and xanthine oxidase inhibition in liver ischemia reperfusion

Clinical characteristics of inflammatory bowel disease associated with primary sclerosing cholangitis

Autoimmune pancreatitis mimicking pancreatic cancer

Complications of the treatment of endoscopic biliary strictures developing after liver transplantation