An easy and secure pancreaticogastrostomy after pancreaticoduodenectomy: transpancreatic suture with a buttress method through an anterior gastrotomy
홍태호, 윤영철, 유영경, 김동구,
소속 상세정보
홍태호 ( Hong Tae-Ho )
Catholic University Seoul St. Mary’s Hospital Department of Surgery
윤영철 ( Youn Young-Chul )
Catholic University Incheon St. Mary’s Hospital Department of Surgery
유영경 ( You Young-Kyoung )
Catholic University Seoul St. Mary’s Hospital Department of Surgery
김동구 ( Kim Dong-Goo )
Catholic University Seoul St. Mary’s Hospital Department of Surgery
KMID : 0371320110810050332
Abstract
Purpose: The aim of this report was to describe a new reconstructive technique of pancreaticogastrostomy and to also discuss this procedure’s effectiveness for reducing the incidence of postoperative complications.
Methods: We retrospectively analyzed early surgical outcomes in 21 consecutive patients who underwent this novel pancreaticogastrostomy after pancreaticoduodenectomy. Pancreaticogastrostomy was completed with 2 transpancreatic sutures with buttresses on both the upper and lower edges of the implanted pancreas through the retracted anterior gastrotomy.
Results: Operative mortality was zero and morbidity was 23.8%. A significant pancreatic fistula occurred in 1 patient (4.7%; grade B).
Conclusion: This technique is very easy to perform, less traumatic to the pancreatic stump, can be performed through a mini-laparotomy due to good vision and straight sutures, and it is secure owing to anchoring of the invaginated pancreatic stump to the stomach’s posterior wall with buttresses. The results of this pilot study indicate that the technique may provide a favorable outcome and could be an alternative method of pancreatoenteric anastomosis. However, to determine its superiority over the conventional procedures, this operative technique should be evaluated more comprehensively in a larger series.
키워드
Pancreatic fistula; Pancreatoenteric anastomosis; Anterior gastrotomy
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