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
. 2018 Apr 23;18(1):53.
doi: 10.1186/s12876-018-0777-z.

Pancreatic duct obstruction after pancreaticojejunostomy: implications for early prediction and prevention of long-term pancreatic complications

Lingfu Zhang  1 , Dianrong Xiu  2 , Chunhui Yuan  1 , Bin Jiang  1 , Zhaolai Ma  1
Affiliations

Pancreatic duct obstruction after pancreaticojejunostomy: implications for early prediction and prevention of long-term pancreatic complications

Lingfu Zhang et al. BMC Gastroenterol. .

Abstract

Background: Pancreatic duct obstructions are common in patients with pancreaticoduodenectomy. However, it is often neglected in follow up. This study was to review the outcomes of pancreatic duct obstruction and explore the prevention of pancreatic duct obstruction.

Methods: A retrospective analysis of 78 patients undergoing pancreaticojejunostomy without reccurence of disease within 24 months between 2004 and 2014. Pancreatic duct obstruction and long-term pancreatic complications were analysed.

Results: Twenty-five patients developed pancreatic duct obstruction following pancreaticojejunostomy, 13 of whom were found to have long-term pancreatic complications. The presence of pancreatic duct obstruction and early pancreatic obstruction were associated with long-term pancreatic complications, respectively (p = 0.002, p = 0.002). There are 10 patients with pancreatic duct stent more than 24 months, the postoperative median pancreatic parenchymal thickness in these 10 patients (17.1 mm, range 8.0 to 24.7 mm) was not significantly change than the median in them preoperative (16.4 mm, range 7.2 to 24.7 mm; p = 0.747). All of them have no long-term pancreatic complications, though the difference was not significantly (p = 0.068).

Conclusions: Early pancreatic duct obstruction is associated with postoperative pancreatic long-term complications. Sustained internal pancreatic stent may improve pancreatic duct obstruction.

Keywords: Pancreatic duct obstruction; Pancreaticojejunostomy; Postoperative long-term pancreatic complication.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Clinical Ethics Committee of Peking University Third Hospital. Because this study is a retrospective study, written consent was not obtained from all participants, and the patients’ data were analyzed anonymously. All methods were performed in accordance with the relevant guidelines and regulations.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Diameter of the main pancreatic duct (MPD) (D) and thickness of the pancreas (T) were measured on enhanced computed tomography images. Preoperatively, the values were measured along the line at the left edge of the superior mesenteric vein (SMV). Postoperatively, the parameters were measured at the same area in the remnant pancreas. The degree of pancreatic atrophy was calculated by the results of T – D. Note: Dotted line indicates the thickness of the pancreas; continuous line indicates diameter of the main pancreatic duct
See this image and copyright information in PMC

References

    1. Fernandez-del Castillo C, Morales-Oyarvide V, McGrath D, Wargo JA, Ferrone CR, Thayer SP, Lillemoe KD, Warshaw AL. Evolution of the Whipple procedure at the Massachusetts General Hospital. Surgery. 2012;152(3 Suppl 1):S56–S63. doi: 10.1016/j.surg.2012.05.022. - DOI - PMC - PubMed
    1. Huang JJ, Yeo CJ, Sohn TA, Lillemoe KD, Sauter PK, Coleman J, Hruban RH, Cameron JL. Quality of life and outcomes after pancreaticoduodenectomy. Ann Surg. 2000;231(6):890–898. doi: 10.1097/00000658-200006000-00014. - DOI - PMC - PubMed
    1. Ohgi K, Okamura Y, Yamamoto Y, Ashida R, Ito T, Sugiura T, Aramaki T, Uesaka K. Perioperative computed tomography assessments of the pancreas predict nonalcoholic fatty liver disease after Pancreaticoduodenectomy. Medicine (Baltimore) 2016;95(6):e2535. doi: 10.1097/MD.0000000000002535. - DOI - PMC - PubMed
    1. Murakami M, Kanji K, Kato S, Fujimoto D, Morikawa M, Koneri K, Hirono Y, Goi T, Yamaguchi A. Clinical influence of anastomotic stricture caused by pancreatogastrointestinalstomy following pancreatoduodenectomy. Surg Today. 2017;47(5):581–586. doi: 10.1007/s00595-016-1412-7. - DOI - PubMed
    1. Sikkens EC, Cahen DL, de Wit J, Looman CW, van Eijck C, Bruno MJ. Prospective assessment of the influence of pancreatic cancer resection on exocrine pancreatic function. Br J Surg. 2014;101(2):109–113. doi: 10.1002/bjs.9342. - DOI - PubMed

MeSH terms