Reappraisal of pancreaticojejunostomy after pancreaticoduodenectomy: A report of 86 gases with particular reference to the rate of pancreatic fistulation

Objective: To report our experience of 86 patients who underwent pancreaticoduodenectomy followed by pancreaticojejunostomy, paying particular attention to the rate of fistulation. Design: Retrospective study. Setting: Two teaching hospitals, France. Subjects: 86 patients (58 men and 28 women) who required pancreatic resection for adenocarcinomas of the head of the pancreas (n = 34), chronic pancreatitis (n = 21), cancer of the ampulla of Vater (n = 12), cancer of the distal bile duct (n = 6), or other causes (n = 13). Intervention: Pancreaticoduodenectomy followed by pancreaticojejunostomy with mucosa to mucosa suture. Results: 26 patients (30%) developed complications, 9 (10%) required reoperation, and 8 (9%) died postoperatively. Pancreatic fistulas developed in 2 (2%), one of whom was successfully treated conservatively. The other was reoperated on and died on day 40. Conclusion: Pancreaticojejunostomy after pancreaticoduodenectomy is safe, and the rate of fistulation compares favourably with that after pancreaticogastrostomy (2%).