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Han Qin, Lin Luo, Zexin Zhu, Jiwei Huang
OBJECTIVE: To examine whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the best reconstruction method to reduce occurrence of postoperative complications, especially pancreatic fistula (PF), after pancreaticoduodenectomy (PD). BACKGROUND: PF is one of the most severe complications after PD. The best reconstruction method to reduce occurrence of PF is controversial. Therefore, we carried out this meta-analysis to compare PG with PJ. METHODS: A systematic review was conducted in PubMed, EMBASE, and Cochrane Library to identify studies comparing PG with PJ, published up to October 2015...
October 18, 2016: International Journal of Surgery
Geert Roeyen, Miet Jansen, Laure Ruyssinck, Thiery Chapelle, Aude Vanlander, Bart Bracke, Vera Hartman, Dirk Ysebaert, Frederik Berrevoet
OBJECTIVE: Recently, pancreaticogastrostomy (PG) has attracted renewed interest as a reconstruction technique after pancreaticoduodenectomy (PD), as it may imply a lower risk of clinical pancreatic fistula than reconstruction by pancreaticojejunostomy (PJ). We hypothesise that pancreatic exocrine insufficiency (PEI) is more common during clinical follow-up after PG than it is after PJ. RESEARCH DESIGN AND METHODS: This study compares the prevalence of PEI in patients undergoing PD for malignancy with reconstruction by PG versus reconstruction by PJ...
October 7, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Joan B Gornals, Claudia Consiglieri, Francesc Vida, Carme Loras
No abstract text is available yet for this article.
2016: Endoscopy
P Addeo, S Langella, L Arru, V De Blasi, E Rosso, P Bachellier
No abstract text is available yet for this article.
June 28, 2016: Journal of Visceral Surgery
Sameer Rehman, Affan Umer, Michael Kuncewitch, Ernesto Molmenti
Pancreatic cancer is one of the leading causes of oncologic morbidity and mortality worldwide. The definitive surgical management for pancreatic cancer includes pancreaticoduodenectomy with either anastomosis to, or implantation of remnant pancreas to the stomach (pancreaticogastrostomy) or the jejunum (pancreaticojejunostomy). Operative morbidity and mortality following pancreaticoduodenectomy frequently results from complications associated with a pancreaticojejunal anastomotic leak. Pancreaticogastrostomy is an alternative method of restoring pancreatic continuity with the gut, which has been employed by a number of institutions showing some benefit in operative mortality...
January 2016: Journal of Ayub Medical College, Abbottabad: JAMC
Long R Jiao, Tamara M H Gall, Mikael H Sodergren, Ruifang Fan
BACKGROUND: Central pancreatectomy (CP) is preferred to distal pancreatectomy (DP) for the excision of benign tumours at the neck or body of the pancreas, in order to preserve pancreatic function and the spleen. However, the pancreaticoenterostomy is technically difficult to perform laparoscopically and the postoperative pancreatic fistula (POPF) rate is high. METHODS: A novel laparoscopic reconstruction of the pancreatic stump during CP is described, the laparoscopic long sleeve pancreaticogastrostomy (LPG)...
June 2016: Hepatobiliary Surgery and Nutrition
Mena M Hanna, Rahul Gadde, Casey J Allen, Jonathan P Meizoso, Danny Sleeman, Alan S Livingstone, Nipun Merchant, Danny Yakoub
BACKGROUND: Delayed gastric emptying (DGE) remains an unsolved complication after pancreaticoduodenectomy (PD) with conflicting reports of its cause. We aimed to compare the effect of surgical techniques involving the stomach in PD in lowering the risk of postoperative DGE. METHODS: Online search and review of key bibliographies in PubMed, Medline, Embase, Scopus, Cochrane, and Google Scholar was performed. Studies comparing PD surgical techniques were identified...
May 15, 2016: Journal of Surgical Research
Stefano Crippa, Roberto Cirocchi, Justus Randolph, Stefano Partelli, Giulio Belfiori, Alessandra Piccioli, Amilcare Parisi, Massimo Falconi
PURPOSE: To perform an up-to-date meta-analysis of randomized controlled trials (RCTs) comparing pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) in order to determine the safer anastomotic technique. Compared to existing meta-analysis, new RCTs were evaluated and subgroup analyses of different anastomotic techniques were carried out. METHODS: We conducted a bibliographic research using the National Library of Medicine's PubMed database from January 1990 to July 2015 of RCTs...
June 2016: Langenbeck's Archives of Surgery
Arunchai Chang, Pitulak Aswakul, Varayu Prachayakul
One of the most common symptoms presenting in patients with chronic pancreatitis is pancreatic-type pain. Obstruction of the main pancreatic duct in chronic pancreatitis can be treated by a multitude of therapeutic approaches, ranging from pharmacologic, endoscopic and radiologic treatments to surgical interventions. When the conservative treatment approaches fail to resolve symptomatic cases, however, endoscopic retrograde pancreatography with pancreatic duct drainage is the preferred second approach, despite its well-recognized drawbacks...
April 16, 2016: World Journal of Clinical Cases
Shin-E Wang, Shih-Chin Chen, Bor-Uei Shyr, Yi-Ming Shyr
BACKGROUND: The aim of this study was to compare perioperative outcomes after Blumgart pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) for pancreatic-enteric reconstruction following pancreaticoduodenectomy. METHODS: Data of patients undergoing Blumgart PJ and PG were retrieved from prospectively-collected database. Matched patients in each surgical groups were included based on the Callery risk scoring system for clinically relevant postoperative pancreatic fistula (CR-POPF) (grades B and C)...
March 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
D Ansari, B Tingstedt, G Lindell, I Keussen, D Ansari, R Andersson
BACKGROUND AND AIMS: Hemorrhage is a rare but dreaded complication after pancreatic surgery. The aim of this study was to examine the incidence, risk factors, management, and outcome of postpancreatectomy hemorrhage in a tertiary care center. MATERIALS AND METHODS: A retrospective observational study was conducted on 500 consecutive patients undergoing major pancreatic resections at our institution. Postpancrea-tectomy hemorrhage was defined according to the International Study Group of Pancreatic Surgery criteria...
February 29, 2016: Scandinavian Journal of Surgery: SJS
Eun Young Kim, Young Kyoung You, Dong Goo Kim, Tae Ho Hong
PURPOSE: In this study, we introduced a novel technique, the pancreaticojejunostomy (PJ), which uses only two transpancreatic sutures with buttresses (PJt), and compared the surgical outcomes with previously used methods, especially for hard pancreases. METHODS: A total of 101 patients who underwent pancreaticoduodenectomy with hard pancreases were enrolled and divided into 3 groups according to the method of pancreaticoenteric anastomosis: 30 patients (29.7%) underwent the conventional dunking method (Du), 31 patients (30...
February 2016: Annals of Surgical Treatment and Research
Gian Piero Guerrini, Paolo Soliani, Giuseppe D'Amico, Fabrizio Di Benedetto, Marco Negri, Micaela Piccoli, Giacomo Ruffo, Rafael Jose Orti-Rodriguez, Theodora Pissanou, Giuseppe Fusai
BACKGROUND: The reconstruction of the pancreas after pancreaticoduodenectomy (PD) is a crucial factor in preventing postoperative complications as pancreatic anastomosis failure is associated with a high morbidity rate and contributes to prolonged hospitalization and mortality. Several techniques have been described for the reconstruction of pancreatic digestive continuity in the attempt to minimize the risk of a pancreatic fistula. The aim of this study was to compare the results of pancreaticogastrostomy and pancreaticojejunostomy after PD...
June 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Jacob E Dowden, Eric T Kimchi, E Ramsay Camp, Katherine A Morgan, David B Adams, Kevin F Staveley-O'Carroll
No abstract text is available yet for this article.
November 2015: American Surgeon
Masato Narita, Ryo Matsusue, Hiroaki Hata, Takashi Yamaguchi, Tetsushi Otani, Iwao Ikai
BACKGROUND: Pancreatoenteric anastomotic failure is the main cause of pancreatic fistula after pancreaticoduodenectomy (PD). Double purse-string telescoped pancreaticogastrostomy, reported by Addeo et al., is an easy and safe procedure.1 The aim of this article was to introduce our technique of pancreaticogastrostomy using an atraumatic self-retaining ring retractor (Alexis Wound Retractor(®)) in a patient undergoing subtotal stomach-preserving PD (SSPPD). PATIENT AND METHODS: An 82-year-old woman presented with pancreatic cancer located in the uncinate process of pancreas...
March 2016: Annals of Surgical Oncology
L Schwarz, J Fleming, M Katz, J Lee, T Aloia, N Vauthey, C Conrad
BACKGROUND: Organ-sparing pancreatic resection is important in prophylactic surgery for cystic neoplasms. There is controversy regarding the optimal surgical approach for pancreatic lesions in the neck or proximal body of the pancreas. Central compared with distal pancreatectomy is technically more challenging, but preserves more functional pancreatic tissue. Because of the prophylactic nature of the surgery and long survival of patients with benign and borderline malignant lesions, surgeons need to stratify greater importance to surgical morbidity and sparing pancreatic parenchyma...
March 2016: Annals of Surgical Oncology
Dongwook Oh, Do Hyun Park, Min Keun Cho, Kwangwoo Nam, Tae Jun Song, Sang Soo Lee, Dong-Wan Seo, Sung Koo Lee, Myung-Hwan Kim
BACKGROUND AND AIMS: Recently, EUS-guided pancreatic duct drainage (EUS-PD) has been used for patients in whom endoscopic retrograde pancreatography (ERP) has failed. Stent-related adverse events such as stent migrations, failures in stent placement, or pancreatic fluid leakages have been of concern in transmural plastic stenting procedures. The aim of this study is to evaluate the feasibility and safety of EUS-PD with a fully covered self-expandable metal stent (FCSEMS) for patients with obstructive pancreatitis who failed ERP...
February 2016: Gastrointestinal Endoscopy
Divya Dahiya, Surinder Singh Rana, Lileswar Kaman, Arunanshu Behera
Pancreas is the fourth solid organ injured in blunt abdominal trauma. Isolated pancreatic injury is present in less than 1% of patients. As it is associated with high morbidity and mortality, management is controversial. Isolated pancreatic trauma cases with pancreatic neck transection following blunt abdominal trauma were analyzed. All these patients were treated with immediate surgery involving lesser sac drainage and feeding jejunostomy only. Authors conclude that lesser sac drainage can be used as an alternative to distal pancreatectomy or pancreaticojejunostomy or pancreaticogastrostomy...
June 2015: Polski Przeglad Chirurgiczny
Shyamal Kumar Halder, Prosanta Kumar Bhattacharjee, Partha Bhar, Cinjini Das, Pranjal Pandey, Krishna Pada Rakshit, Anadi Pachaury
Chronic pancreatitis (CP) is a chronic inflammation of pancreas that leads to progressive fibrosis of pancreatic parenchyma. Commonest indication of surgery in chronic pancreatitis is intractable pain. Choice of procedure depends upon the main pancreatic duct (MPD) morphology. Decompression is useful in dilated and obstructed ducts. Traditional form of decompression is construction of a pancreatico-jejunal anastomosis (LPJ). Another method to achieve ductal decompression is by a pancreaticogastrostomy (LPG) and this study will try to evaluate its effectiveness against pancreaticojejunostomy...
April 2015: Indian Journal of Surgery
Masamichi Matsuda, Shusuke Haruta, Hisashi Shinohara, Kazunari Sasaki, Goro Watanabe
BACKGROUND: Although many surgical procedures are now routinely performed laparoscopically, pure laparoscopic pancreaticoduodenectomy (LPD) is not commonly performed because of the technical difficulty of pancreatic resection and the associated reconstruction procedures. Several pancreatic-enteric anastomosis techniques for LPD have been reported, but most are adaptations of open procedures. To accomplish pure LPD, we consider it necessary to establish new pancreatic-enteric anastomosis techniques that are specifically developed for LPD and are safe and feasible to perform...
2015: BMC Surgery
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