Continuous dunking pancreaticojejunostomy: our experience with first fifty cases

Introduction- Different techniques and modifications have been described to bring down the incidence of pancreatic fistula rate. However, no techniques have been accepted as a gold standard. Since 2011, we have been performing pancreaticojejunostomy by continuous dunking technique. Here, we intend...

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Autores principales:	Ramesh Singh Bhandari, Paleswan Joshi Lakhey
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2016
Materias:	Pancreaticoduodenectomy Pancreatic fistula Braun’s anastomosis Surgery RD1-811
Acceso en línea:	https://doaj.org/article/2e42ecb0e0c1487abbeef70b3a85421c
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spelling	oai:doaj.org-article:2e42ecb0e0c1487abbeef70b3a85421c2021-12-05T19:16:34ZContinuous dunking pancreaticojejunostomy: our experience with first fifty cases10.3126/jssn.v18i3.153071815-39842392-4772https://doaj.org/article/2e42ecb0e0c1487abbeef70b3a85421c2016-07-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/15307https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction- Different techniques and modifications have been described to bring down the incidence of pancreatic fistula rate. However, no techniques have been accepted as a gold standard. Since 2011, we have been performing pancreaticojejunostomy by continuous dunking technique. Here, we intend to present our experience with the defined technique. Methods: Prospectively maintained medical records of the patients (operated between Sept 2011 to Jan 2016) undergoing pancreaticoduodenectomy and pancreaticoenteric reconstruction by continuous dunking techniques were reviewed and analyzed. Postoperative complications mainly, incidence of post pancreatectomy fistula (POPF), hemorrhage (PPH) and delayed gastric emptying (DGE) along with other major complications were analyzed. Subgroup analysis was also performed to find the difference in fistula rate in patients with or without addition of Braun’s anastomosis. ISGPS definition was used to define the major, surgery specific complications of pancreaticoduodenectomy. Results: Total 51 patients underwent pancreaticojejunostomy with the defined technique with Male to female ratio of 23:28. Total 13.7% (7/51) patients received preoperative biliary drainage. Overall, clinically significant fistula rated was 15.6% (8/51), PPH 13.7% (7/51) and 0% clinically significant DGE (overall DGE 13.7%, 7/51). Mortality rate was 5.8% (3/51). Subgroup analysis performed between patients with or without addition of Braun’s anastomosis revealed 0% clinically significant fistula rate with no mortality in the group. Conclusion: Surgery specific complications following pancreaticoduodenectomy and pancreaticoenteric reconstruction with our technique are comparable to published results from high volume centers. Addition of Braun’s anastomosis is a promising modification to bring down the POPF rate to a minimum. Ramesh Singh BhandariPaleswan Joshi LakheySociety of Surgeons of NepalarticlePancreaticoduodenectomyPancreatic fistulaBraun’s anastomosisSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 18, Iss 3 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pancreaticoduodenectomy Pancreatic fistula Braun’s anastomosis Surgery RD1-811
spellingShingle	Pancreaticoduodenectomy Pancreatic fistula Braun’s anastomosis Surgery RD1-811 Ramesh Singh Bhandari Paleswan Joshi Lakhey Continuous dunking pancreaticojejunostomy: our experience with first fifty cases
description	Introduction- Different techniques and modifications have been described to bring down the incidence of pancreatic fistula rate. However, no techniques have been accepted as a gold standard. Since 2011, we have been performing pancreaticojejunostomy by continuous dunking technique. Here, we intend to present our experience with the defined technique. Methods: Prospectively maintained medical records of the patients (operated between Sept 2011 to Jan 2016) undergoing pancreaticoduodenectomy and pancreaticoenteric reconstruction by continuous dunking techniques were reviewed and analyzed. Postoperative complications mainly, incidence of post pancreatectomy fistula (POPF), hemorrhage (PPH) and delayed gastric emptying (DGE) along with other major complications were analyzed. Subgroup analysis was also performed to find the difference in fistula rate in patients with or without addition of Braun’s anastomosis. ISGPS definition was used to define the major, surgery specific complications of pancreaticoduodenectomy. Results: Total 51 patients underwent pancreaticojejunostomy with the defined technique with Male to female ratio of 23:28. Total 13.7% (7/51) patients received preoperative biliary drainage. Overall, clinically significant fistula rated was 15.6% (8/51), PPH 13.7% (7/51) and 0% clinically significant DGE (overall DGE 13.7%, 7/51). Mortality rate was 5.8% (3/51). Subgroup analysis performed between patients with or without addition of Braun’s anastomosis revealed 0% clinically significant fistula rate with no mortality in the group. Conclusion: Surgery specific complications following pancreaticoduodenectomy and pancreaticoenteric reconstruction with our technique are comparable to published results from high volume centers. Addition of Braun’s anastomosis is a promising modification to bring down the POPF rate to a minimum.
format	article
author	Ramesh Singh Bhandari Paleswan Joshi Lakhey
author_facet	Ramesh Singh Bhandari Paleswan Joshi Lakhey
author_sort	Ramesh Singh Bhandari
title	Continuous dunking pancreaticojejunostomy: our experience with first fifty cases
title_short	Continuous dunking pancreaticojejunostomy: our experience with first fifty cases
title_full	Continuous dunking pancreaticojejunostomy: our experience with first fifty cases
title_fullStr	Continuous dunking pancreaticojejunostomy: our experience with first fifty cases
title_full_unstemmed	Continuous dunking pancreaticojejunostomy: our experience with first fifty cases
title_sort	continuous dunking pancreaticojejunostomy: our experience with first fifty cases
publisher	Society of Surgeons of Nepal
publishDate	2016
url	https://doaj.org/article/2e42ecb0e0c1487abbeef70b3a85421c
work_keys_str_mv	AT rameshsinghbhandari continuousdunkingpancreaticojejunostomyourexperiencewithfirstfiftycases AT paleswanjoshilakhey continuousdunkingpancreaticojejunostomyourexperiencewithfirstfiftycases
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Continuous dunking pancreaticojejunostomy: our experience with first fifty cases

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