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06 June 2015
George Baytchev1, Ivan Inkov1, Nikola Kyuchukov1, Emilia Zlateva2 1) Department Of Thoracic Surgery, Military Medical Academy, Sofia, Bulgaria. 2) Department Of Radiology, Hospital

PANCREATOGASTROSTOMY WITH ONE CONTINUOUS SEROMUSCULAR CIRCULAR SUTURE

Daniel Vasilev Kostov1, Georgi Kobakov2, Daniel Yankov1

1) Department of Surgery, Naval Hospital of Varna, Bulgaria.

2) Division of Surgery, Specialized Hospital of Oncological Diseases of Varna, Varna, Bulgaria.

Disclosure: The author has declared no conflicts of interest.

Received: 30.03.15 Accepted: 20.04.15

1486385429 Quote  doi: 10.5455/ijsm.20150411090731

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Abstract:

One of the most feared complications after pancreaticoduodenectomy (PD) remains postoperative pancreatic fistula (POPF). In the current study, we demonstrate a new technique for pancreaticogastrostomy (PG), using one continuous seromuscular circular suture without trans pancreas sutures for PG.

Material and Methods
During the period December 2012 to December 2014, 32 consecutive patients underwent PD (either pylorus-preserving or classical Whipple’s) carried out using the above suture-less PG. Indication for PD was pancreatic duct carcinoma. Procedures were carried out by the same surgeon, same approach and anastomotic method in order to avoid technical changes.

Results
Postoperative mortality was zero and morbidity was 21.8% (n=7). Pancreatic leakage (Grade A/B) occurred in 2 (6.2%) patients. These pancreatic leaks were managed nonoperative by maintaining the closed drains. The most common postoperative complication delayed gastric emptying (Grade B/C) in 3 (9.3%) patients.

Conclusion
We conclude that the suture-less PG possesses several advantages over conventional PG and pancreaticojejunostomy (PJ). This technic seems to lessen the risk of a pancreatic leak, probably by diminishing the possibility of suture damage to the pancreas and by embedding the transected stump into the posterior gastric wall. This novel PG is a valid and valuable procedure, especially for soft, nonfibrotic pancreas.

Keywords: Pancreaticoduodenectomy; Pancreaticogastrostomy; Suture-less pancreaticogastrostomy; Postoperative pancreatic fistula

References

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How to Cite this Article

Bibliography

Kostov, D., Kobakov, G. and Yankov, D. (2015) ‘PANCREATOGASTROSTOMY WITH ONE CONTINUOUS SEROMUSCULAR CIRCULAR SUTURE’, International Journal of Surgery and Medicine, 1(1), pp. 2–6. doi: 10.5455/ijsm.20150411090731.

Citations, Quotes & Annotations

Kostov, D., Kobakov, G. and Yankov, D. (2015) ‘PANCREATOGASTROSTOMY WITH ONE CONTINUOUS SEROMUSCULAR CIRCULAR SUTURE’, International Journal of Surgery and Medicine, 1(1), pp. 2–6. doi: 10.5455/ijsm.20150411090731.
(Kostov, Kobakov, and Yankov, 2015)
 

Cited by:

 
1. Kostov D, Kobakov G. Is Sutureless Pancreaticogastrostomy More Effective than Single-Layer Duct-to-Mucosa Pancreaticojejunostomy in Pancreaticoduodenectomy? The Eurasian Journal of Medicine. 2017;49(2):79-86. doi:10.5152/eurasianjmed.2017.17002.

2. Godara R, Tamaknand V, Verma S. A novel pancreatogastrostomy method using only one purse string suture and four corner mucosal sutures: early post operative surgical results. Int J Surg Med. 2018; 4(1): 28-32. doi:10.5455/ijsm.pancreatogastrostomy-using-only-one-purse-string-suture-four-corner-mucosal-sutures

3. Kostov, Daniel Vasilev. “Lymphadenectomy in Pancreatic Cancer Surgery.” (2016).

4. Kostov, Daniel, Georgi Kobakov, and Daniel Yankov. "Mesopancreas excision for pancreatic head adenocarcinoma". Surg Chron 2016; 21(3): 117-121
 
 
PANCREATOGASTROSTOMY WITH ONE CONTINUOUS SEROMUSCULAR CIRCULAR SUTURE

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Last modified onSaturday, 18 August 2018 09:25