Roux-en-Y reconstruction after pancreaticoduodenectomy Journal Article
| Authors: | Grobmyer, S. R.; Hollenbeck, S. T.; Jaques, D. P.; Jarnagin, W. R.; DeMatteo, R.; Coit, D. G.; Blumgart, L. H.; Brennan, M. F.; Fong, Y. |
| Article Title: | Roux-en-Y reconstruction after pancreaticoduodenectomy |
| Abstract: | Hypothesis: Roux-en-Y reconstruction (RYR) is associated with a reduction in morbidity and mortality associated with pancreatic anastomotic failure after pancreaticoduodenectomy compared with conventional loop reconstruction (CLR). Design: Retrospective study of patients from 1991 to 2006. Setting: Tertiary care center. Patients: Records of patients undergoing CLR (n=588) and patients undergoing RYR (n=112) between February 1, 1991, and June 30, 2006, for pancreatic ductal adenocarcinoma at a single institution were retrospectively reviewed and compared. Main Outcome Measures: Perioperative outcome and mortality were compared for patients who underwent RYR compared with those who underwent CLR. Results: Overall, both groups required a similar rate of postoperative interventional radiology procedures (CLR, 6.8%; RYR, 9.8%; P=.24) and subsequent operations (CLR, 6.9%; RYR, 9.1%; P=.62). No significant difference was found in the rate of overall postoperative mortality (CLR, 2.6%; RYR, 0.9%; P=.49). The overall rate of pancreatic anastomotic failure was 7.2%, and pancreatic anastomotic failure was associated with a 6% mortality rate. Among patients who developed pancreatic anastomotic failure, no significant difference was seen between CLR (n=32) and RYR (n=16) in length of hospital stay (18 vs 19 days; P=.98) or postoperative mortality (3 patients [9.4%] vs none [0%]; P=.54). Conclusion: We found that RYR is not associated with a reduction in morbidity after pancreaticoduodenectomy for pancreatic adenocarcinoma compared with CLR, even among patients who develop pancreatic anastomotic failure. ©2008 American Medical Association. All rights reserved. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; surgical technique; retrospective studies; major clinical study; mortality; plastic surgery; treatment duration; cancer patient; pancreaticoduodenectomy; adenocarcinoma; morbidity; carcinoma, pancreatic ductal; retrospective study; cancer mortality; pancreas carcinoma; hospitalization; statistical significance; medical record; medical society; interventional radiology; pancreas adenocarcinoma; surgical mortality; intermethod comparison; perioperative period; tertiary health care; anastomosis; radiodiagnosis; anastomosis, surgical; roux y anastomosis; hypothesis; conventional loop reconstruction; anastomosis, roux-en-y |
| Journal Title: | Archives of Surgery |
| Volume: | 143 |
| Issue: | 12 |
| ISSN: | 0004-0010 |
| Publisher: | American Medical Association |
| Date Published: | 2008-01-01 |
| Start Page: | 1184 |
| End Page: | 1188 |
| Language: | English |
| DOI: | 10.1001/archsurg.2008.501 |
| PUBMED: | 19075170 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 17 November 2011" - "CODEN: ARSUA" - "Source: Scopus" |
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