A Prospctive Trial Of Inserting Pancreaticogastrostomy Versus Conventional Pancreaticojejunostomy After Pancreaticoduodenectomy

Objective：To compare the results of postoperative morbidity rate of a modified duct-to-mucosa pancreatogastrostomy technique, Inserting pancreaticogastrostomy(IPG) with thetechnique of conventional pancreaticojejunostomy (CPJ) following pancreaticoduodenectomyMethods: A total of185patients undergoing pancreatoduodenectomy with two differenttechnique of pancreatic digestive tract reconstruction including IPG and CPJ were analyzed in aprospective and controlled setting, during September2009to December2012.Result: IPG (n=93) and CPJ (n=92) groups of total185patients showed no differences inpreoperative parameters,intraoperative factors and the overall incidence of pancreatic fistula（graded A+B+C）,while pancreatic fistula(graded B+C) occurred only2patients (2.2%) in IPGgroup compared with12patients (13%)in CPJ groups(P=0.005).The overall postoperativecomplications developed in41patients (44.6%)in the CPJ group compared with28patients (30.1%)in IPG group. IPG group was favored over CPJ group due to significant differences in biliaryfistula (P=0.016), intraperitoneal infection and abscess (P=0.007).The postoperative hospital stay(mean±SD) for CPJ group was25.3±14.5days which significantly longer than IPG group16.8±7.2days(P<0.001).Conclusions: IPG after panceaticoduodenectomy is a safe reliable and effective technique ofpancreatic digestive tract reconstruction, which significantly decreased postoperative complicationand pancreatic fistula（gradesB、C） rates and shortened hospital stay when compared with CPJ.