Comparison between the outcome of pancreaticogastrostomy and pancreaticojejunostomy after pancreaticoduodenectomy: a cross-sectional study

Rasel Mahmud; S. M. Mortaza Ahsan; M. Mustafizur Rahman; M. Abdul Quiyum; M. Zabiul Islam; Mohammad M. Rahman; Mostafa M. Warid; Asma Sultana

doi:10.18203/2349-2902.isj20242109

Authors

Rasel Mahmud Department of Hepatobiliary Surgery, Sylhet M. A. G. Osmani Medical College, Sylhet, Bangladesh
S. M. Mortaza Ahsan Sheikh Russel National Gastroliver Institute and Hospital, Mohakhali, Dhaka, Bangladesh
M. Mustafizur Rahman Department of Hepatobiliary Surgery, Sheikh Russel National Gastroliver Institute and Hospital, Mohakhali, Dhaka, Bangladesh
M. Abdul Quiyum Department of Surgery, 300 Bedded Hospital, Narayanganj, Bangladesh
M. Zabiul Islam Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
Mohammad M. Rahman Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
Mostafa M. Warid Department of Hepatobiliary Surgery, Aichi Medical College, Demra, Dhaka, Bangladesh
Asma Sultana Sheikh Russel National Gastroliver Institute and Hospital, Mohakhali, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-2902.isj20242109

Keywords:

Pancreaticoduodenectomy, Pancreaticogastrostomy, Pancreaticojejunostomy, Pancreatic fistula, Anastomosis

Abstract

Background: Complications of pancreatic stump reconstruction after pancreaticoduodenectomy (PD) can lead to severe morbidity or even mortality. This study is taken to see the postoperative outcome of pancreatico-gastrostomy (PG) over pancreaticojejunostomy (PJ) after PD. Aim of the study was to compare the outcomes of PG and PJ following PD in a cross-sectional analysis.

Methods: This comparative cross-sectional study was done in the department of hepatobiliary pancreatic and liver transplant surgery, BSMMU, Dhaka. A total of twenty-five patients (N=25), who underwent PD from July 2019 to June 2020, were included in this study. These patients were divided into two group, group A with PG (n=10) and group B with PJ (n=15). All patients were evaluated before and after surgery for assessing post-operative outcome by clinically, biochemically and radiologically.

Results: This study showed no significant differences in demographic characteristics, co-morbidity and post-operative outcomes/complications between this two groups. However, PG demonstrated significantly shorter anastomosis time and required fewer sutures than PJ. Although a higher incidence of wound infections was observed in PJ compared to PG, these differences were not statistically significant. Peri-operative mortality did not significantly differ between the two techniques. Though postoperative hospital stay was shorter in the PG group compared to PJ but the difference was not statistically significant.

Conclusions: PG can be considered as a safe and alternative procedure after PD.

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