Abstract
Pancreaticoduodenectomy (PD) is the standard surgical treatment for resectable pancreatic head cancer. After resections, the reconstruction of the gastrointestinal continuity could be performed in different fashions. The aim of this review is to evaluate the different techniques of enteric reconstruction of pancreatic stump after PD: Invagination pancreaticojejunostomy, binding pancreaticojejunostomy, duct-to-mucosa pancreaticojejunostomy, Roux-en-Y pancreaticojejunostomy, and pancreaticogastrostomy. These gastric or enteric reconstructions are compared in terms of postoperative complications, postoperative pancreatic fistula, delayed gastric emptying, and mortality.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Neoptolemos JP, Stocken DD, Friess H, Bassi C, Dunn JA, Hickey H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med. 2004;350:1200–10.
Whipple AO. Treatment of carcinoma of the ampulla of Vater. Ann Surg. 1935;102:763–8. (abstract)
Kausch W. Das Karzinoma der Papilla duodeni and seine radikale Entfernung. Betir Klin Chir. 1912;78:439–86. (abstract)
Gudjonsson B. Cancer of the pancreas. 50 years of surgery. Cancer. 1987;60:2284–303.
Gudjonsson B. Carcinoma of the pancreas: critical analysis of costs, results of resections, and the need for standardized reporting. J Am Coll Surg. 1995;181:483–503.
Büchler MW, Friess H, Wagner M, Kulli C, Wagener V, Z’Graggen K. Pancreatic fistula after pancreatic head resection. Br J Surg. 2000;87(7):883–9.
Schorn S, Demir IE, Vogel T, et al. Mortality and postoperative complications after different types of surgical reconstruction following pancreaticoduodenectomy—a systematic review with meta-analysis. Langenbeck’s Arch Surg. 2019;404:141–57.
Tan WJ, Kow AW, Liau KH. Moving towards the New International Study Group for Pancreatic Surgery (ISGPS) definitions in pancreaticoduodenectomy: a comparison between the old and new. HPB (Oxford). 2011;13:566–72.
Wente MN, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, Izbicki JR, Neoptolemos JP, Padbury RT, Sarr MG, Traverso LW, Yeo CJ, Buchler MW. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007;142(5):761–8.
Hunt VC. Surgical management of carcinoma of the ampulla of vater and of the periampullary portion of the duodenum. Ann Surg. 1941;114(4):570–602.
Bassi C, Dervenis C, Butturini G, International Study Group on Pancreatic Fistula Definition, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138(1):8–13.
Böttger TC, Junginger T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: critical analysis of 221 resections. World J Surg. 1999;23(2):164–71. discussion 171–2
Cheng Q, Zhang B, Zhang Y, Jiang X, Zhang B, Yi B, Luo X, Wu M. Predictive factors for complications after pancreaticoduodenectomy. J Surg Res. 2007;139(1):22–9.
Peng SY, Wang JW, Li JT, Mou YP, Liu YB, Cai XJ. Pancreaticojejunostomy—a safe and reliable anastomosis procedure. HPB (Oxford). 2004;6(3):154–60.
Buc E, Flamein R, Golffier C, Dubois A, Nagarajan G, Futier E, et al. Peng’s binding pancreaticojejunostomy after pancreaticoduodenectomy: a French prospective study. J Gastrointest Surg. 2010;14:705–10.
Nordback I, Räty S, Laukkarinen J, Järvinen S, Piironen A, Leppiniemi J, et al. A novel radiopaque biodegradable stent for pancreatobiliary applications—the first human phase I trial in the pancreas. Pancreatology. 2012;12:264–71.
Hashimoto D, Hirota M, Yagi Y, H. Baba End-to-side pancreaticojejunostomy without stitches in the pancreatic stump. Surg Today. 2013;43(7):821–4.
Varco RL. A method of implanting the pancreatic duct into the jejunum in the Whipple operation for carcinoma of the pancreas: case report. Surgery. 1945;18:569–73.
Bassi C, Falconi M, Molinari E, Mantovani W, Butturini G, Gumbs AA, Salvia R, Pederzoli P. Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: results of a prospective randomized trial. Surgery. 2003;134(5):766–71.
Lee SE, Yang SH, Jang JY, Kim SW. Pancreatic fistula after pancreaticoduodenectomy: a comparison between the two pancreaticojejunostomy methods for approximating the pancreatic parenchyma to the jejunal seromuscular layer: interrupted vs. continuous stitches. World J Gastroenterol. 2007;13(40):5351–6.
Waugh JM, Clagett OT. Resection of the duodenum and head of pancreas for carcinoma: an analysis of thirty cases. Surgery. 1946;20:224–32.
McKay A, Mackenzie S, Sutherland FR, et al. Meta-analysis of pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy. BJS. 2006;93(8):929–36.
Martin RF, Zuberi KA. The evidence for technical considerations in pancreatic resections for malignancy. Surg Clin N Am. 2010;90(2):265–85.
He T, Zhao Y, Chen Q, Wang X, Lin H, Han W. Pancreaticojejunostomy versus pancreaticogastrostomy after pancreaticoduodenectomy: a systematic review and meta-analysis. Dig Surg. 2013;30(1):56–9.
Fabre JM, Arnaud JP, Navarro F, Bergamaschi R, Cervi C, Marrel E, Domergue J. Results of pancreatogastrostomy after pancreatoduodenectomy in 160 consecutive patients. Br J Surg. 1998;85(6):751–4.
Lemaire E, O’Toole D, Sauvanet A, Hammel P, Belghiti J, Ruszniewski P. Functional and morphological changes in the pancreatic remnant following pancreaticoduodenectomy with pancreaticogastric anastomosis. Br J Surg. 2000;87(4):434–8.
Rault A, SaCunha A, Klopfenstein D, Larroudé D, Epoy FN, Collet D, Masson B. Pancreaticojejunal anastomosis is preferable to pancreaticogastrostomy after pancreaticoduodenectomy for long-term outcomes of pancreatic exocrine function. J Am Coll Surg. 2005;201(2):239–44.
Dubernard JM, Traeger J, Neyra P, Touraine JL, Blanc N, Devonec M. Long-term effect of néoprène injection in the canine pancreatic duct. Transplant Proc. 1979;11:1498–9.
Suc B, Msika S, Fingerhut A, Fourtanier G, Hay JM, Holmières F, Sastre B, Fagniez PL. Temporary fibrin glue occlusion of the main pancreatic duct in the prevention of intra-abdominal complications after pancreatic resection: prospective randomized trial. Ann Surg. 2003;237:57–65.
Koti RS, Gurusamy KS, Fusai G, Davidson BR. Meta-analysis of randomized controlled trials on the effectiveness of somatostatin analogues for pancreatic surgery: a Cochrane review. HPB (Oxford). 2010;12:155–65.
Mimatsu K, Oida T, Kano H, Kawasaki A, Fukino N, Kida K, Kuboi Y, Amano S. Protection of major vessels and pancreaticogastrostomy using the falciform ligament and greater omentum for preventing pancreatic fistula in soft pancreatic texture after pancreaticoduodenectomy. Hepato-Gastroenterology. 2011;58:1782–6.
Poon RT, Fan ST, Lo CM, Ng KK, Yuen WK, Yeung C, Wong J. External drainage of pancreatic duct with a stent to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. Ann Surg. 2007;246:425–33. discussion 433–435
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Bellido-Luque, J., Sanchez-Matamoros Martin, I., Gonzalez-Fernandez, D., Nogales Muñoz, A. (2023). Pancreatic Surgical Resections. In: Bellido Luque, J., Muñoz, A.N. (eds) Recent Innovations in Surgical Procedures of Pancreatic Neoplasms. Springer, Cham. https://doi.org/10.1007/978-3-031-21351-9_8
Download citation
DOI: https://doi.org/10.1007/978-3-031-21351-9_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-21350-2
Online ISBN: 978-3-031-21351-9
eBook Packages: MedicineMedicine (R0)