Roux-en-Y Reconstruction after pancreaticoduodenectomy reduced
gastrojejunostomy anastomosis-related complication
Palin Limpavitayaporn MD.*, Ekkapak Sriussadaporn MD.*, Assignee
Tongyoo MD.*, Chatchai Mingmalairak MD.*
*Division of Hepatopancreatobiliary Surgery, Department of
Surgery, Faculty of Medicine, Thammasat university, Pathumthani,
Thailand.
INTRODUCTION Pancreaticoduodenectomy has been accepted as a
therapeutic option for patients with periampullary cancer since
1935. Post-operative pancreatic fistula is the most common
complication, with the rate ranging from 5% to 40%.
Gastrojejunostomy-related complication is not uncommon, such as
marginal ulcer, bile reflux gastritis and afferent and efferent
loop obstruction.
OBJECTIVE The objective of this study was to review the
experience of conventional reconstruction versus Roux-en-Y
reconstruction after pancreaticoduodenectomy in a series of
patients who underwent pancreatic head resection.MATERIALS AND
METHODS
We retrospectively reviewed and analyzed the data of the
patients who had undergone pancreaticoduodenectomy with either
conventional reconstruction or Roux-en-Y reconstruction techniques
in Thammasat University Hospital between January 2012 and August
2016.RESULTS The overall incidence of post-operative pancreatic
fistula was 15.7%, without significant difference in the two
groups. Overall mortality, blood loss, operative time and length of
stay were also similar in the two groups. The conventional
reconstruction group had significantly higher rate of
gastrojejunostomy-retaled complications such as afferent and
efferent loop obstruction 21.6%, upper gastrointestinal bleeding
caused from marginal ulcer 15.7%. (P
