A retrospective analysis of 88 patients with pancreaticogastrostomy after pancreaticoduodenectomy

Background/Aims: Recently, pancreaticogastrostomy after pancreaticoduodened omy has been reintroduced as a useful procedure with a low incidence of pan creatic leakage. We decided to retrospectively analyze the early postoperat ive and fate follow-up complications in a large number of patients who had undergone our improved pancreaticogastrostomy. Methodology: Between August 1993 and November 1998, we performed pancreatic ogastrostomy following pancreaticoduodenectomy in 88 consecutive patients i ncluding pylorus preservation in 14. Our pancreaticogastrostomy used a two- layer implantation method using a pancreatic duct stent with an. anterior g astrotomy. Results: The morbidity and mortality rates were 5.7% and 0%, respectively. There were no cases of pancreatic leakage and no postoperative complication s directly related to the pancreaticogastrostomy. As for gastric emptying, the average time until resumption feeding was 12 days, without significant difference between pancreaticogastrostomy and pylorus-presenting pancreatic ogastrostomy As to late follow-up complications, diabetes developed postope ratively in 6.5% (4/62) patients, and of 14 patients who were shown by magn etic resonance cholangiopancreatography, 5 (35.7%) developed pancreatic duc tal dilatation after surgery. Conclusions: These results from a relatively large group conclusively prove the safety of pancreatico-gastrostomy and indicate that the follow-up qual ity of life is good under the circumstances.