REAPPRAISAL OF PANCREATICOJEJUNOSTOMY AFTER PANCREATICODUODENECTOMY -A REPORT OF 86 GASES WITH PARTICULAR REFERENCE TO THE RATE OF PANCREATIC FISTULATION

Objective: To report our experience of 86 patients who underwent pancr eaticoduodenectomy followed by pancreaticojejunostomy, paying particul ar attention to the rate of fistulation. Design: Retrospective study. Setting: Two teaching hospitals, France. Subjects: 86 patients (58 men and 28 women) who required pancreatic resection for adenocarcinomas o f the head of the pancreas (n = 34), chronic pancreatitis (n = 21), ca ncer of the ampulla of Vater (n = 12), cancer of the distal bile duct (n = 6), or other causes (n = 13). Intervention: Pancreaticoduodenecto my followed by pancreaticojejunostomy with mucosa to mucosa suture. Re sults: 26 patients (30%) developed complications, 9 (10%) required reo peration, and 8 (9%) died postoperatively. Pancreatic fistulas develop ed in 2 (2%), one of whom was successfully treated conservatively. The other was reoperated on and died on day 40. Conclusion: Pancreaticoje junostomy after pancreaticoduodenectomy is safe, and the rate of fistu lation compares favourably with that after pancreaticogastrostomy (2%) .