A comparative study of the retention or removal of jejunal mucosa during pancreatic duct to jejunal anastomosis.

AIM: The aim of this study was to compare the two anastomosis methods, that is, the retention or the removal of the jejunal mucosa during pancreatic duct to jejunal anastomosis after pancreaticoduodenectomy (PD).

METHODS

For this purpose, 46 PD patients were randomly and equally divided into groups A and B. In group A, the remnant pancreas was inserted 3 cm into the jejunum and the connecting part was sutured. In group B, the jejunal mucous membrane was cauterized 3 cm at the end, the remnant pancreas was sutured with the jejunal muscle layer, and the jejunum and pancreas were sutured together.

RESULTS

We found that in group A, the reoperation rate due to delayed bleeding was 13% (3/23) and the ulcer bleeding around anastomosis was 4.3% (1/23). In group B, the reoperation rate due to bleeding was 4.3% (1/23) and the incidence of postoperative pancreatic fistula was 17.4% (4/23). The duration of pancreaticojejunostomy operation in group A (46 ± 0.34 min) was shorter than in group B (P<0.001).

CONCLUSION

We, therefore, concluded that the pancreatic duct to jejunal anastomosis with retained jejunal mucosa was a simple and easy to perform method while it also excluded the risk of postoperative pancreatic fistula formation.