Abstract

 

Aim: a prospective study to compare PG versus PJ after PD in Assuit.

Methods: From July. 2005 to Jan. 2008, 30 patients were included, and randomized into PG, and PJ groups, then followed up for evaluation morbidity and mortality.

Results: PD resection followed PG in 16 patients (53.3%), and PJ in 14 patients (46.6%). no difference observed as regard patient characteristics, pre-operative, and intra-operative parameters.

No peri-operative mortality, however the morbidity rate was 36.6%, most of complications belong to PJ group include pancreatic fistula (6.6%), biliary leakage (3.3%), pancreatitis (3.3%), delayed gastric emptying (3.3%), and wound infection (3.3%), in comparison to abdominal collection (3.3%), bleeding gastric margin (3.3%), peptic ulceration (3.3%), cholangitis (3.3%), and wound infection (3.3%) in PG group.

Statistically significant difference observed as regard the total number of complicated patients in favor of PG (43%, versus 31%), and pancreatic fistula was encountered in 2 cases in PJ group, however no significant difference detected as regard hospital stay, or drain output.  

Conclusions: PG should be always considered after PD as it is safer, with lower incidence of associated complications.

Keywords: Pancreatico-duodenectomy, pancreatic anastomosis, pancreatic fistula.