• S Takano, Y Ito, H Oishi, S Kono, T Yokoyama, N Kubota, and S Iwai.
• Third Department of Surgery, Nihon University, Tokyo, Japan.
• Hepato Gastroenterol. 2000 Sep 1;47(35):1454-7.

Background/AimsRecently, pancreaticogastrostomy after pancreaticoduodenectomy has been reintroduced as a useful procedure with a low incidence of pancreatic leakage. We decided to retrospectively analyze the early postoperative and late follow-up complications in a large number of patients who had undergone our improved pancreaticogastrostomy.MethodologyBetween August 1993 and November 1998, we performed pancreaticogastrostomy following pancreaticoduodenectomy in 88 consecutive patients including pylorus preservation in 14. Our pancreaticogastrostomy used a two-layer implantation method using a pancreatic duct stent with an anterior gastrotomy.ResultsThe morbidity and mortality rates were 5.7% and 0%, respectively. There were no cases of pancreatic leakage and no postoperative complications directly related to the pancreaticogastrostomy. As for gastric emptying, the average time until resumption feeding was 12 days, with no significant difference between pancreaticogastrostomy and pylorus-preserving pancreaticogastrostomy. As to late follow-up complications, diabetes developed postoperatively in 6.5% (4/62) patients, and of 14 patients who were shown by magnetic resonance cholangiopancreatography, 5 (35.7%) developed pancreatic ductal dilatation after surgery.ConclusionsThese results from a relatively large group conclusively prove the safety of pancreaticogastrostomy and indicate that the follow-up quality of life is good under the circumstances.

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