Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Mar 7;21(9):2731-8.
doi: 10.3748/wjg.v21.i9.2731.

Continuous suture of the pancreatic stump and Braun enteroenterostomy in pancreaticoduodenectomy

Hong-Bo Meng  1 , Bo Zhou  1 , Fan Wu  1 , Jie Xu  1 , Zhen-Shun Song  1 , Jian Gong  1 , Mahbuba Khondaker  1 , Bin Xu  1
Affiliations

Continuous suture of the pancreatic stump and Braun enteroenterostomy in pancreaticoduodenectomy

Hong-Bo Meng et al. World J Gastroenterol. .

Abstract

Aim: To investigate a new modification of pancreaticoduodenectomy (PD)-a mesh-like running suturing of the pancreatic remnant and Braun's enteroenterostomy.

Methods: Two hundred and three patients underwent PD from 2009 to 2014 and were classified into two groups: Group A (98 patients), who received PD with a mesh-like running suturing for the pancreatic remnant, and Braun's enteroenterostomy; and Group B (105 patients), who received standard PD. Demographic data, intraoperative findings, postoperative morbidity and perioperative mortality between the two groups were compared by univariate and multivariate analysis.

Results: Demographic characteristics between Group A and Group B were comparable. There were no significant differences between the two groups concerning perioperative mortality, and operative blood loss, as well as the incidence of the postoperative morbidity, including reoperation, bile leakage, intra-abdominal fluid collection or infection, and postoperative bleeding. Clinically relevant postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE) were identified more frequently in Group B than in Group A. Technique A (PD with a mesh-like running suturing of the pancreatic remnant and Braun's enteroenterostomy) was independently associated with decreased clinically relevant POPF and DGE, with an odds ratio of 0.266 (95%CI: 0.109-0.654, P = 0.004) for clinically relevant POPF and 0.073 (95%CI: 0.010-0.578, P = 0.013) for clinically relevant DGE.

Conclusion: An additional mesh-like running suturing of the pancreatic remnant and Braun's enteroenterostomy during PD decreases the incidence of postoperative complications and is beneficial for patients.

Keywords: Braun’s enteroenterostomy; Delayed gastric emptying; Pancreaticoduodenectomy; Postoperative pancreatic fistula; Running suture.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Key surgical procedures of the technique. A: Management of the pancreatic remnant; B: Braun enteroenterostomy in pancreaticoduodenectomy.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Topal B, Fieuws S, Aerts R, Weerts J, Feryn T, Roeyen G, Bertrand C, Hubert C, Janssens M, Closset J. Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial. Lancet Oncol. 2013;14:655–662. - PubMed
    1. Inchauste SM, Lanier BJ, Libutti SK, Phan GQ, Nilubol N, Steinberg SM, Kebebew E, Hughes MS. Rate of clinically significant postoperative pancreatic fistula in pancreatic neuroendocrine tumors. World J Surg. 2012;36:1517–1526. - PMC - PubMed
    1. Hackert T, Bruckner T, Dörr-Harim C, Diener MK, Knebel P, Hartwig W, Strobel O, Fritz S, Schneider L, Werner J, et al. Pylorus resection or pylorus preservation in partial pancreatico-duodenectomy (PROPP study): study protocol for a randomized controlled trial. Trials. 2013;14:44. - PMC - PubMed
    1. Nikfarjam M, Kimchi ET, Gusani NJ, Shah SM, Sehmbey M, Shereef S, Staveley-O’Carroll KF. A reduction in delayed gastric emptying by classic pancreaticoduodenectomy with an antecolic gastrojejunal anastomosis and a retrogastric omental patch. J Gastrointest Surg. 2009;13:1674–1682. - PubMed
    1. Sakamoto Y, Yamamoto Y, Hata S, Nara S, Esaki M, Sano T, Shimada K, Kosuge T. Analysis of risk factors for delayed gastric emptying (DGE) after 387 pancreaticoduodenectomies with usage of 70 stapled reconstructions. J Gastrointest Surg. 2011;15:1789–1797. - PubMed

Publication types

MeSH terms

LinkOut - more resources