Outcomes of pancreatogastrostomy with gastric partition after pylorus-preserving pancreaticoduodenectomy with gastric partition

Abstract

Introduction: Pylorus-preserving pancreatoduodenectomy with gastric partition (PPPD-GP) seems to be associated to a better postoperative outcome than conventional pancreaticojejunostomy in the setting of a prospective-randomized study. The aim of this study is to further evaluate the surgical outcome in a series of 129 consecutive patients.

Methods: Between 2007 and June 2013, 129 patients with periampullary tumors surgically treated with PPPD-GP were retrospectively analyzed. Surgical complications (Clavien-Dindo score), as well as pancreatic and non-pancreas related complications were analyzed.

Results: Overall postoperative complication rate was 77%, although 50% of complications were graded I-II by the Clavien-Dindo classification. Incidence of clinically relevant pancreatic fistula was 18%: ISGFP type B: 12%, and type C: 6%. Other pancreas specific complications such as delayed gastric emptying and pospancreatectomy haemorrhage were 27 and 15%, respectively, similar to results published in the literature. Overall perioperative mortality rate was 4.6%.

Conclusion: PPPD-GP results show that it is a technique with an acceptable morbidity, low mortality and pancreatic fistula rate similar to other techniques currently described of pancreaticoenteric reconstruction.

Keywords: Cirugía pancreática; Complicaciones; Complications; Delayed gastric emptying; Duodenopancreatectomía; Fístula pancreática; Pancreatic fistula; Pancreatic surgery; Pancreaticoduodenectomy; Pancreatogastrostomy; Pancreatogastrostomía; Retraso del vaciamiento gástrico.