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The 1-year outcomes after pancreaticogastrostomy using vertical versus horizontal mattress suturing for gastric wrapping

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Abstract

Purpose

To investigate the differences in nutritional status 1 year after pancreaticogastrostomy (PG) using vertical suturing (VS) vs. twin square horizontal mattress (HMS) suturing in patients undergoing pancreaticoduodenectomy (PD).

Methods

The subjects of this study were 134 patients who underwent PD, followed by PG, which was closed by VS in 52 and by HMS in 82. We evaluated the peri- and postoperative factors, nutritional parameters, diameter of the remnant main pancreatic duct, and glucose intolerance 1 year postoperatively.

Results

Forty-five (87%) patients from the VS group and 75 (91%) patients from the HMS group survived for more than 1 year. The incidences of intraabdominal abscess and pancreatic fistula were significantly lower in the HMS group than in the VS group (19.2% vs. 6.6% and19.2% vs. 2.6%, respectively). There were no significant changes in the total protein, serum albumin, and HbA1c levels 1 year postoperatively. The postoperative expansion ratio of the main pancreatic duct diameter was significantly smaller in the HMS group than in the VS group. The strongest risk factor for body weight loss 1 year postoperatively was a non-soft pancreas texture.

Conclusion

HMS was superior to VS for preventing early postoperative complications and did not affect pancreatic function.

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Acknowledgements

We thank the data manager of our department for collecting medical data from Kagoshima University Hospital electronic medical records.

Funding

This study had no funding.

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Authors and Affiliations

  1. Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan

    Kosei Maemura, Yuko Mataki, Hiroshi Kurahara, Kiyonori Tanoue, Yota Kawasaki, Tetsuya Ijichi, Satoshi Iino & Shoji Natsugoe

  2. Clinical Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan

    Shinichi Ueno

  3. Kagoshima University Graduate School of Health Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan

    Hiroyuki Shinchi

Authors
  1. Kosei Maemura
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  2. Yuko Mataki
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  3. Hiroshi Kurahara
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  4. Kiyonori Tanoue
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  5. Yota Kawasaki
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  7. Satoshi Iino
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  9. Hiroyuki Shinchi
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  10. Shoji Natsugoe
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Contributions

Study conception and design; KM, SN. Acquisition of data; KM, YM, HK, YK, KT, MH. Analysis and interpretation of data; KM, S, MS, SU, HS. Drafting of manuscript; KM. Critical revision of manuscript; SU, HS, SN.

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Correspondence to Kosei Maemura.

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Maemura, K., Mataki, Y., Kurahara, H. et al. The 1-year outcomes after pancreaticogastrostomy using vertical versus horizontal mattress suturing for gastric wrapping. Surg Today 51, 511–519 (2021). https://doi.org/10.1007/s00595-020-02134-z

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  • DOI: https://doi.org/10.1007/s00595-020-02134-z

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