Clinical study on cystogastrostomy and Roux-en-Y-type cystojejunostomy in the treatment of pancreatic pseudocyst: A single-center experience

Medicine (Baltimore). 2021 Mar 12;100(10):e25029. doi: 10.1097/MD.0000000000025029.

Abstract

The main purpose is to compare the efficacy of cystogastrostomy (CG) and Roux-en-Y-type cystojejunostomy (RCJ) in the treatment of pancreatic pseudocyst (PPC), and to explore the risk factors of recurrence and complications after internal drainage.Two hundred eight patients undergoing either CG or RCJ for PPC Between January 1, 2013and February 1, 2019, at West China Hospital of Sichuan University were retrospectively analyzed. The cure rate, complication rate and related factors were compared between the 2 groups.Two hundred eight patients with PPC underwent either a CG (n = 119) or RCJ (n = 89). The median follow-up time was 42.7 months. Between the 2 cohorts, there were no significant differences in cure rate, reoperation rate, and mortality (all P > .05). The operative time, estimated intraoperative blood loss, install the number of drainage tubes and total expenses in CG group were lower than those in RCJ group (all P < .05). The Logistic regression analysis showed that over twice of pancreatitis' occurrence was were independent risk factor for recurrence after internal drainage of PPC (OR 2.760, 95% CI 1.006∼7.571, P = .049). Short course of pancreatitis (OR 0.922, 95% CI 0.855∼0.994, P = .035), and RCJ (OR 2.319, 95% CI 1.033∼5.204, P = .041) were independent risk factors for complications after internal drainage of PPC.Both CG and RCJ are safe and effective surgical methods for treating PPC. There were no significant differences in cure rate, reoperation rate, and mortality between the 2 groups, while the CG group had a short operation time, less intraoperative bleeding and less cost.

MeSH terms

  • Adult
  • Anastomosis, Roux-en-Y / adverse effects
  • Blood Loss, Surgical
  • Drainage / adverse effects
  • Drainage / methods*
  • Female
  • Gastrostomy / adverse effects
  • Gastrostomy / methods*
  • Humans
  • Jejunostomy / adverse effects
  • Jejunostomy / methods*
  • Male
  • Middle Aged
  • Operative Time
  • Pancreatic Pseudocyst / etiology
  • Pancreatic Pseudocyst / mortality
  • Pancreatic Pseudocyst / surgery*
  • Pancreatitis / complications
  • Pancreatitis / epidemiology*
  • Pancreatitis / surgery
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome