Clinical Studies On The Reconstruction By Pancreaticogastrostomy Following Pancreaticoduodenectomy

Objective: To investigate clinical application of pancreaticogastrostomy afterpancreaticoduodenectomy and experience of treatment of pancreatic fistula. Methods: Aretrospective review was performed for50patients who underwentpancreaticogastrostomy after pancreaticoduodenectomy at the First Affiliated Hospital ofXinjiang Medical University from December2010to December2012. Thepancreaticogastrostomy was performed by a invagination technique to the posterior gastricwall using interrupted silk sutures, the pancreatic fistula was divided into A, B, C gradesby measuring the amylase level in fluid obtained from surgically placed drains, the meanoperative time, mean was respectively. Among the groups compared with the incidence ofpostoperative complications, drainage fluid amylase concentration, intraoperative bloodtransfusion, intraoperative bleeding and length of postoperative hospital stay. Results:The procedures were successful in all patients. The mortality rate of Postoperativepancreatic fistula included: A grade was22%(11/50) of the patients, B grade was10%(5/50), and C grade was4%(2/50); the incidence of other postoperative complicationsincluded: the mortality rate of gastrointestinal anastomotic fistula was2%(1/50); themortality rate of intra-abdominal bleeding was2%, and the mortality rate ofgastrointestinal bleeding was4%. Conclusions: The application ofpancreaticogastrostomy after pancreaticoduodenectomy is effective and safe, and it caneffectively prevent the occurrence of pancreatic fistula. Only complicated withintra-abdominal bleeding, intra-abdominal abscess, surgical intervention will beconsidered.