A PROSPECTIVE ANALYSIS OF THE FACTORS INFLUENCING PANCREATICOJEJUNOSTOMY PERFORMED USING A SINGLE METHOD, IN 100 CONSECUTIVE PANCREATICODUODENECTOMIES

Citation
S. Matsusue et al., A PROSPECTIVE ANALYSIS OF THE FACTORS INFLUENCING PANCREATICOJEJUNOSTOMY PERFORMED USING A SINGLE METHOD, IN 100 CONSECUTIVE PANCREATICODUODENECTOMIES, Surgery today, 28(7), 1998, pp. 719-726
Citations number
20
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
ISSN journal
0941-1291
Volume
28
Issue
7
Year of publication
1998
Pages
719 - 726
Database
ISI
SICI code
0941-1291(1998)28:7<719:APAOTF>2.0.ZU;2-Q
Abstract
The factors influencing the healing process of pancreaticojejunostomy (P-J) following pancreaticoduodenectomy (PD) are still ill defined, al lowing the recommendation of various anastomotic methods. We conducted a prospective study to determine the risk factors influencing the pro tracted healing of P-J, examining 100 consecutive patients who underwe nt PD followed by P-J, performed as an end-to-side ''mucosa-to-mucosa' ' anastomosis using vertical mattress sutures (VMS method). Protracted healing of P-J was classified as either peripancreatic sepsis (PPS), defined as prolonged suppurative discharge of less than 50 ml a day fr om the drain beneath the P-J for more than 1 week; or a pancreatic fis tula (PF), defined as prolonged discharge of more than 50 mi a day wit h a high amylase content (>1 000 IU) for more than 1 week. There were 80 patients with a malignant neoplasm, and 20 with benign disease. The overall incidence of healing problems following P-J was 9%, which inc luded 6 patients (6%) with PPS and 3 (3%) with PF, Apart from an advan ced age of more than 70 gears, none of the patients' characteristics o r postoperative complications influenced the healing of P-J, The type of reconstruction, an anastomotic stent, the duct size, and a ''soft'' pancreas were not risk factors either. In conclusion, no factors, apa rt from the age or any special problem of an individual patient, influ enced the dehiscence of P-J when the VMS method was used after PD.