Pancreaticogastrostomy versus pancreaticojejunostomy following pancreaticoduodenectomy for periampullary carcinoma.

Fourteen patients underwent pancreaticoduodenectomy between January 1991 and February 1995 for periampullary carcinoma. In the first 8 patients pancreaticojejunostomy was performed; two of them developed pancreatic leak and died. In the subsequent 6 patients, pancreaticogastrostomy was performed; in this group there was no pancreatic leak and no perioperative mortality. THere was no difference between the two groups in preoperative bilirubin level, duration of jaundice, diameters of the common bile duct and pancreatic duct at surgery, operative time and blood loss. Postoperatively, the patients undergoing pancreaticogastrostomy fared better; they were started on oral feeds earlier (6.0 +/- 0.6 vs 10.2 +/- 0.8 days, p < 0.001), became ambulatory earlier (7.2 +/- 0.4 vs 12.3 +/- 1.5 days, p < 0.001) and had less loss of body weight at the time of discharge (2.2 +/- 0.2 vs 3.8 +/- 0.4 Kg, p < 0.001).