[Is Peng's pancreaticojejunal anastomosis more effective than mucosa-mucosa anastomosis in duodenopancreatectomy for pancreatic and peri-ampullary tumours?]. 2013

Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
Departamento de Cirugía General, Hospital Edgardo Rebagliati Martins, Lima, Perú. jtargaronam@gmail.com

BACKGROUND The pancreatic fistula is the most feared complication after a duodenopancreatectomy, and is the most common independent factor of post-surgical mortality. Peng et al. recently published a pancreaticojejunal anastomosis technique (binding anastomosis) which showed 0% pancreatic fistulas. The objective of this study is to evaluate and validate this new anastomosis technique compared with the conventional pancreaticoduodenectomy with end-to-side duct-to-mucosa anastomosis. METHODS A prospective, non-randomised study was conducted to evaluate and validate this new anastomosis technique compared with the conventional pancreaticojejunal terminolateral duct to mucosa anastomosis. The study included 63 patients who were subjected to a duodenopancreatectomy due to having a pancreatic or periampullary neoplasm. A binding pancreaticojejunostomy according to the technique described by Peng et al. was performed on 30 patients (Group A), and a pancreaticoduodenectomy with end-to-side duct-to-mucosa anastomosis (conventional technique) was performed on 33 patients (Group B). RESULTS When the results of the 2 techniques were compared, 2/30 (6%) of patients had a pancreatic fistula with the Peng technique, and 4/33 (12%) with the conventional technique, but this was not statistically significant (P=.674). Nor were there any significant differences between the 2 groups on comparing, morbidity, hospital stay and mortality. CONCLUSIONS The results of this study show that the anastomosis method described by Peng is safe, but is not associated with a lower frequency of pancreatic fistula, general morbidity, or mortality. This leads to the uncertainty of whether it really has any advantages over other techniques.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009092 Mucous Membrane An EPITHELIUM with MUCUS-secreting cells, such as GOBLET CELLS. It forms the lining of many body cavities, such as the DIGESTIVE TRACT, the RESPIRATORY TRACT, and the reproductive tract. Mucosa, rich in blood and lymph vessels, comprises an inner epithelium, a middle layer (lamina propria) of loose CONNECTIVE TISSUE, and an outer layer (muscularis mucosae) of SMOOTH MUSCLE CELLS that separates the mucosa from submucosa. Lamina Propria,Mucosa,Mucosal Tissue,Muscularis Mucosae,Mucous Membranes,Membrane, Mucous,Membranes, Mucous,Mucosae, Muscularis,Mucosal Tissues,Propria, Lamina,Tissue, Mucosal,Tissues, Mucosal
D010185 Pancreatic Fistula Abnormal passage communicating with the PANCREAS. Fistula, Pancreatic,Fistulas, Pancreatic,Pancreatic Fistulas
D010190 Pancreatic Neoplasms Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA). Cancer of Pancreas,Pancreatic Cancer,Cancer of the Pancreas,Neoplasms, Pancreatic,Pancreas Cancer,Pancreas Neoplasms,Pancreatic Acinar Carcinoma,Pancreatic Carcinoma,Acinar Carcinoma, Pancreatic,Acinar Carcinomas, Pancreatic,Cancer, Pancreas,Cancer, Pancreatic,Cancers, Pancreas,Cancers, Pancreatic,Carcinoma, Pancreatic,Carcinoma, Pancreatic Acinar,Carcinomas, Pancreatic,Carcinomas, Pancreatic Acinar,Neoplasm, Pancreas,Neoplasm, Pancreatic,Neoplasms, Pancreas,Pancreas Cancers,Pancreas Neoplasm,Pancreatic Acinar Carcinomas,Pancreatic Cancers,Pancreatic Carcinomas,Pancreatic Neoplasm
D010193 Pancreaticojejunostomy Surgical anastomosis of the pancreatic duct, or the divided end of the transected pancreas, with the jejunum. (Dorland, 28th ed) Pancreatojejunostomy,Pancreaticojejunostomies,Pancreatojejunostomies
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003138 Common Bile Duct Neoplasms Tumor or cancer of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
January 1983, Presse medicale (Paris, France : 1983),
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
January 2006, Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru,
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
September 2021, The lancet. Gastroenterology & hepatology,
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
September 2021, The lancet. Gastroenterology & hepatology,
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
November 2015, World journal of gastrointestinal surgery,
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
January 2007, Journal of gastrointestinal cancer,
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
May 2004, Gastrointestinal endoscopy,
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
January 2008, Surgical technology international,
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
August 2005, Journal of the American College of Surgeons,
Javier Targarona, and Luis Barreda, and Elizabeth Pando, and Claudia Barreda
August 2020, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology,
Copied contents to your clipboard!