The 1-year outcomes after pancreaticogastrostomy using vertical versus horizontal mattress suturing for gastric wrapping
- PDF / 847,109 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 21 Downloads / 158 Views
ORIGINAL ARTICLE
The 1‑year outcomes after pancreaticogastrostomy using vertical versus horizontal mattress suturing for gastric wrapping Kosei Maemura1 · Yuko Mataki1 · Hiroshi Kurahara1 · Kiyonori Tanoue1 · Yota Kawasaki1 · Tetsuya Ijichi1 · Satoshi Iino1 · Shinichi Ueno2 · Hiroyuki Shinchi3 · Shoji Natsugoe1 Received: 7 May 2020 / Accepted: 28 July 2020 © Springer Nature Singapore Pte Ltd. 2020
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. Keywords Horizontal mattress suture · Pancreatic function · Pancreaticogastrostomy · Pancreaticoduodenectomy
Introduction Pancreaticoduodenectomy (PD) is the standard treatment for malignant or benign periampullary lesions; however, the morbidity associated with this surgery is still unacceptably high and its reported operative complication rate is > 30% [1]. Postoperative pancreatic fistula (POPF) is one of the most common and serious postoperative complications after PD [2]. A variety of techniques for pancreatic remnant * Kosei Maemura [email protected] 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
2
Clinical Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, 8‑35‑1 Sakuragaoka, Kagoshima, Japan
3
Kagoshima University Graduate School of Health Sciences, 8‑35‑1 Sakuragaoka, Kagoshima, Japan
reconstruction have been devised to reduce the incidence of postoperative complications such as POPF [3–6]. The main options for pancreatic reconstruction are pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG). Although observational studies suggested that PG is a safer reconstruction procedure than PJ, several recent meta-analyses indicate that
Data Loading...
