Current experience with pancreatogastrostomy

摘要: Background The reconstruction technique for the pancreatic remnant remaining after pancreatoduadenectomy has most frequently been pancreatojejunostomy. Although mortality rate hag reduced to rather low levels in many centers, leakage from this anastomosis remains high, range of 10% or greater. An alternative reconstruction, pancreatogastrostomy, known almost 50 years and performed on small numbers patients. is less than 1% literature reports more 200 purpose report was add previously reported experience with compare it standard as a major American medical center by experienced surgeons. Methods records all patients operated at Loyola University Medical Center Edward Hines, Jr., Veteran's Affairs Hospital August 1986 May 1993, procedure code relating pancreas, were reviewed. Results A total 58 Whipple procedures identified, including 34 pancreatogastrostomies, 23 pancreatojejunostomies 1 stapled stump. No leaks any pancreatogastrostomies observed 38 so treated, whereas 4 2 deaths related occurred group panereatojejunostomies. average length stay 14.2 days pancreatojejunostomy 15.5 pancreatogastrostomy group, excluding duration data those who died leakage. There no significant difference between pancreactogactrostomy; there statistically lengthening whose leaked versus did not leak. 10 having pylorus-sparing operation had an postoperative 16 days, both types reconstruction. Conclusions gradual adoption led abandonment pancreatoduodenectomy.