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Observational Study
. 2016 Dec;18(12):1017-1022.
doi: 10.1016/j.hpb.2016.09.002. Epub 2016 Oct 7.

Pancreatic exocrine insufficiency after pancreaticoduodenectomy is more prevalent with pancreaticogastrostomy than with pancreaticojejunostomy. A retrospective multicentre observational cohort study

Geert Roeyen  1 , Miet Jansen  2 , Laure Ruyssinck  3 , Thiery Chapelle  4 , Aude Vanlander  3 , Bart Bracke  4 , Vera Hartman  4 , Dirk Ysebaert  4 , Frederik Berrevoet  3
Affiliations
Observational Study

Pancreatic exocrine insufficiency after pancreaticoduodenectomy is more prevalent with pancreaticogastrostomy than with pancreaticojejunostomy. A retrospective multicentre observational cohort study

Geert Roeyen et al. HPB (Oxford). 2016 Dec.

Abstract

Objective: Recently, pancreaticogastrostomy (PG) has attracted renewed interest as a reconstruction technique after pancreaticoduodenectomy (PD), as it may imply a lower risk of clinical pancreatic fistula than reconstruction by pancreaticojejunostomy (PJ). We hypothesise that pancreatic exocrine insufficiency (PEI) is more common during clinical follow-up after PG than it is after PJ.

Research design and methods: This study compares the prevalence of PEI in patients undergoing PD for malignancy with reconstruction by PG versus reconstruction by PJ. PEI during the first year of follow-up was defined as the intake of pancreatic enzyme replacement therapy (PERT) within one year postoperatively and/or an abnormal exocrine function test.

Results: A total of 186 patients, having undergone surgery at two university hospitals, were included in the study. PEI during the first year postoperatively was present in 75.0% of the patients with PG, compared to 45.7% with PJ (p < 0.001). Intake of PERT within one year after surgery was found to be more prevalent in the PG group, i.e. 75.8% versus 38.5% (p < 0.001). There was a trend towards more disturbed exocrine function tests after PG (p = 0.061).

Conclusions: PEI is more common with PG reconstruction than with PJ reconstruction after pancreaticoduodenectomy for malignancy.

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Figures

Figure 1
Figure 1
AJCC stage of subgroup of patients having undergone surgery for pancreatic head adenocarcinoma (125/186 patients; in percentages)
See this image and copyright information in PMC

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