Background: Pancreatic anastomotic leakage is a common problem after pancreaticoduodenectomy and is a leading cause of postoperative morbidity and mortality. It is important to establish a safe and simple technique of pancreatic-enteric anastomosis to minimize pancreatic leakage.
Patients and methods: From July 2009 to February 2012, a new method of mesh-reinforced pancreaticogastrostomy was performed in 13 patients after completion of the pancreaticoduodenal resection. Patient demographic data, pathology of lesions, operative parameters, and postoperative outcomes were analyzed.
Results: The mean operative time was 6.9 hours (range, 5-11 hours), and the mean time for pancreaticogastrostomy was 25 minutes (range, 22-35 minutes). Intraoperative tests showed all pancreatic anastomoses were watertight. There was no postoperative death. No patient developed clinically significant pancreatic leakage (grade B or C) after operation; 1 patient (7.7%) was recognized to have a grade A pancreatic leakage. No significant complication (hemorrhage, intra-abdominal abscess, or cholangitis) was observed. The mean postoperative hospital stay was 20 days (range, 11-30 days). After discharge, all patients recovered well in the 4-week follow-up period without emergency room visit or re-admission.
Conclusions: The mesh-reinforced pancreaticogastrostomy provides a new way to perform pancreatic-enteric drainage after pancreaticoduodenectomy and has the advantages of simplicity, ease of handling, and applicability to all types of pancreatic remnants.