Reappraisal of pancreaticojejunostomy after pancreaticoduodenectomy: a report of 86 cases with particular reference to the rate of pancreatic fistulation.

OBJECTIVE

To report our experience of 86 patients who underwent pancreaticoduodenectomy followed by pancreaticojejunostomy, paying particular 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 of the head of the pancreas (n = 34), chronic pancreatitis (n = 21), cancer of the ampulla of Vater (n = 12), cancer of the distal bile duct (n = 6), or other causes (n = 13).

INTERVENTION

Pancreaticoduodenectomy followed by pancreaticojejunostomy with mucosa to mucosa suture.

RESULTS

26 patients (30%) developed complications, 9 (10%) required reoperation, and 8 (9%) died postoperatively. Pancreatic fistulas developed in 2 (2%), one of whom was successfully treated conservatively. The other was reoperated on and died on day 40.

CONCLUSION

Pancreaticojejunostomy after pancreaticoduodenectomy is safe, and the rate of fistulation compares favourably with that after pancreaticogastrostomy (2%).