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Minerva Chirurgica 2020 May 26

DOI: 10.23736/S0026-4733.20.08338-8


lingua: Inglese

Comparison between two different reconstruction techniques after pancreatic head resection

Eugenio MORANDI 1, Carlo CORBELLINI 1 , Marco CASTOLDI 1, Andrea de VUONO 2, Laura PISONI 1, Gianandrea VIGNATI 1

1 General Surgery Department, ASST Rhodense, Rho Hospital, Milan, Italy; 2 Department of Statistics, ASST Rhodense, Rho Hospital, Milan, Italy


BACKGROUND: The study aim is to evaluate if diverting drainage of bile and pancreatic secretions with an isolated Roux loop technique helps to decrease the rate of postoperative morbidity and mortality, in particular postoperative pancreatic fistula (POPF).
METHODS: A prospectively-maintained database between 2006 and 2018 was reviewed. Patients who underwent primary elective pancreaticoduodenectomy were included. Two types of reconstruction methods were compared: single loop (SJL) reconstruction (28 patients) and isolated Roux-en-Y (DJL) reconstruction (36 patients). Demographic characteristics and perioperative results were compared between the two groups.
RESULTS: This study includes 64 patients. The average duration of surgery was 308 mins; it was longer for DJL (p < 0,0001). Major postoperative complications were seen in 24 patients (9 in SJL; 15 in DJL) without statistically significant difference. The most frequent complication that occurred was PJ anastomosis failure (4 in SJL; 6 in DJL). The choice of postoperative complication management was not related to surgical reconstruction technique (p 0.389). Length of hospital stay in DJL was significantly longer than in SJL (p 0.04).
CONCLUSIONS: No significant advantage of one technique over the other was found. In our opinion, surgeons should choose the approach with which they have the most experience and ease.

KEY WORDS: Pancreatic disease; Reconstruction techniques; Pancreatic head resection; Pancreatic surgery

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