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- W4240863362 abstract "Background: Postoperative pancreatic fistula (POPF) continues to dominate the spectrum of complications of pancreaticoduodenectomy (PD). Selective use of pancreaticogastrostomy (PG) instead of pancreaticojejunostomy (PJ) may lead to reduction in rate and severity of POPF. Methods: Retrospective chart review of all PD performed between 2009 and 2016 was conducted with respect to intraoperative gland assessment (soft vs. hard), duct size (< 3mm was considered small) and postoperative outcomes. The pancreatic remnant was classified as “high-risk” if at least one risk factor (soft gland, small duct) was present. Results: 141 patients underwent PD at a single institution. PG was done in 49 (34.8%) and PJ in 71 (70.6%) patients. All PGs were done for high-risk remnant while PJ was performed in both groups. Clinically relevant POPF developed in 15 patients (10.8%); no significant difference between PG and PJ was observed (8.3% vs. 11.1%, respectively). The leaks after PJ occurred more often in patients with high risk remnants: 32% vs. 4.5%, p=0.005. In contrast, PG performed in a similar group of patients, was associated with significantly lower POPF rate: 8.3% vs. 32%, p=0.016). Gland texture, risk group affiliation, BMI, but not duct size or blood loss, were strong predictors of POPF on univariate analysis. Gland texture appeared to be the strongest predictor on multivariate analysis. Conclusion: PG offers substantial reduction in the rate and severity of POPF in patients with high-risk gland compared to PJ." @default.
- W4240863362 created "2022-05-12" @default.
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- W4240863362 date "2019-01-01" @default.
- W4240863362 modified "2023-09-30" @default.
- W4240863362 title "Moderating postoperative pancreatic fistula achieved by selective use of pancreaticogastrostomy" @default.
- W4240863362 doi "https://doi.org/10.1016/j.hpb.2019.10.610" @default.
- W4240863362 hasPublicationYear "2019" @default.
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