Current pancreatogastrointestinal anastomotic methods: results of a Japanese survey of 3109 patients

Abstract

Pancreatogastrointestinal anastomosis is the most important anastomotic method of reconstructing the digestive tract following pancreaticoduodenectomy. We therefore conducted a survey on pancreatogastrointestinal anastomosis at the 28th Japan Pancreatic Surgery Club in 2001. Results revealed that of the methods of pancreatogastrointestinal anastomosis, pancreatojejunostomy (82.9%) was overwhelmingly more popular than pancreatogastrostomy (17.1%). Anastomotic leakage occurred in 12.8% of cases, and 13.0% of these patients died. The incidence of anastomotic leakage was 11.0% with pancreatogastrostomy, and 13.3% with pancreatojejunostomy. There was no significant difference in the development of anastomotic leakage among the anastomotic organ used with the pancreas, the pancreas resection method, and the pancreatic juice drainage method. Investigation of intra-abdominal hemorrhage and abscess, which are serious complications that result from anastomotic leakage, revealed that intra-abdominal hemorrhage occurred in 1.1% of all cases, and intra-abdominal abscess was seen in 3.3% of all cases. However, there were no significant differences between pancreatogastrostomy and pancreatojejunostomy with respect to incidence rates of intra-abdominal hemorrhage and abscess or mortality. The method of pancreatogastrointestinal anastomosis should be chosen according to each individual case.