Evaluation of pancreaticogastrostomy using pancreas-transfixing sutures versus a single purse-string seromascular nonpancreatic suture in Whipple operation: a prospective randomized-controlled trial

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Abstract

Background
Pancreatic fistula (PF) remains a persistent problem after pancreaticoduodenectomy (PD). The existence of soft, nonfibrotic pancreatic tissue is one of the critical risks for pancreatic leakage. Our aim was to compare continuous single purse-string sutures and transfixing suture for performing pancreaticogastrostomy to the pancreatic stump in terms of the outcome and the rate of postoperative complications for PD.
Patients and methods
Our study included 40 patients who were diagnosed with different stages of pancreatic cancer and admitted to the general surgery department of Suez Canal University Hospital. These patients were enrolled in the study and underwent PD.
Results
The rate of postoperative PF rate was lower when using single purse-string suture for performing pancreaticogastrostomy than when using the transfixing suture (0 vs. 15%, respectively).
Conclusion
We found a link between the occurrence of postoperative PF and possible risk factors such as soft pancreas and small Wirsung duct diameter.

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