Study of early follow-up of pancreatojejunostomy (duct to mucosa) after pancreaticoduodenectomy: a retrospective study from January 2017 to November 2020

Eldesoky, Mohamed; Kassem, Amr; Kandil, Tharwat; Elmahdy, Youssif

doi:10.4103/ejs.ejs_322_21

Study of early follow-up of pancreatojejunostomy (duct to mucosa) after pancreaticoduodenectomy: a retrospective study from January 2017 to November 2020

Authors

Abstract

Introduction
There is a great debate for the best technique of pancreatic reconstruction following pancreaticoduodenectomy (PD). The aim of the study was to follow-up early complications and outcomes regarding pancreatojejunostomy (PJ) (duct to mucosa) for pancreatic anastomosis performed at our center regarding postoperative morbidity and mortality.
Patients and methods
In this study, we reviewed the data of the patients who were treated by PD with pancreatic reconstruction by PJ (duct to mucosa) at the Gastroenterology Surgical Center, Mansoura, Egypt, during the period from January 2017 to November 2020. The primary outcome measure was the rate of postoperative pancreatic fistula, delayed gastric emptying, bile leak, and postoperative morbidity and mortality.
Results
A total of 44 patients treated by PD were included in the study and followed up. The median age of study patients was 57 years. Regarding preoperative biliary drainage endoscopic retrograde cholangiopancreatography (ERCP), 43% of cases were stented within 1 month preoperatively. The median operative time for reconstruction was 39 min. Postoperative pancreatic fistula developed in 8/44 patients, whereas hospital mortality was 2/44 patients.
Conclusion
Duct-to-mucosa PJ was relatively effective, particularly in small-sized pancreatic duct and soft friable consistency of pancreatic tissue, which can be difficult in other anastomotic types owing to parenchymal laceration, especially in comparison with other types of pancreaticoenteric anastomotic methods.

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