Pancreaticogastrostomy: A novel application after central pancreatectomy

Michael Goldstein, Jared Toman, John A. Chabot

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background Limited middle segment pancreatectomy, or central pancreatectomy, has been described for sparing normal pancreatic tissue during resection of benign neoplasms of the pancreatic neck. Anatomic reconstruction after central pancreatectomy has been reported in other series with creation of a Roux-en-Y loop of jejunum for a mucosa-to-mucosa pancreaticojejunostomy. Study design Hospital charts and outpatient records were reviewed for 12 consecutive patients undergoing central pancreatectomy from August 1999 to November 2002. Results We performed central pancreatectomy with pancreaticogastrostomy in 12 patients: 5 with serous cystadenomas, 6 with mucinous cystadenomas, and 1 with neuroendocrine tumor. All tumors were located in the body or neck of the pancreas, measuring a mean ± standard deviation (SD) of 2.5 ± 1.2 cm. Median postoperative hospital stay was 6.5 days (range 5 to 15 days). There were no intraoperative complications. Perioperative complications included two urinary tract infections and one readmission for acute pancreatitis. There were no pancreatic leaks or fistulas in this series. Two of the 12 patients experienced endocrine insufficiency with elevated glycosylated hemoglobin levels during outpatient followup. None of the 12 patients experienced exocrine insufficiency. Conclusions Central pancreatectomy with pancreaticogastrostomy reconstruction is safe and technically advantageous over Roux-en-Y pancreaticojejunostomy, and should be considered a safe reconstruction technique after central pancreatectomy for benign disease.

Original languageEnglish (US)
Pages (from-to)871-876
Number of pages6
JournalJournal of the American College of Surgeons
Volume198
Issue number6
DOIs
StatePublished - Jun 2004
Externally publishedYes

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Pancreatectomy
Pancreaticojejunostomy
Mucous Membrane
Outpatients
Roux-en-Y Anastomosis
Serous Cystadenoma
Mucinous Cystadenoma
Hospital Design and Construction
Neuroendocrine Tumors
Intraoperative Complications
Glycosylated Hemoglobin A
Jejunum
Urinary Tract Infections
Pancreatitis
Fistula
Pancreas
Length of Stay
Neoplasms

Keywords

  • central pancreatectomy
  • CP
  • pancreaticoduodenectomy
  • pancreaticogastrostomy
  • pancreaticojejunostomy
  • PD
  • PG
  • PJ

ASJC Scopus subject areas

  • Surgery

Cite this

Pancreaticogastrostomy : A novel application after central pancreatectomy. / Goldstein, Michael; Toman, Jared; Chabot, John A.

In: Journal of the American College of Surgeons, Vol. 198, No. 6, 06.2004, p. 871-876.

Research output: Contribution to journalArticle

Goldstein, Michael ; Toman, Jared ; Chabot, John A. / Pancreaticogastrostomy : A novel application after central pancreatectomy. In: Journal of the American College of Surgeons. 2004 ; Vol. 198, No. 6. pp. 871-876.
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abstract = "Background Limited middle segment pancreatectomy, or central pancreatectomy, has been described for sparing normal pancreatic tissue during resection of benign neoplasms of the pancreatic neck. Anatomic reconstruction after central pancreatectomy has been reported in other series with creation of a Roux-en-Y loop of jejunum for a mucosa-to-mucosa pancreaticojejunostomy. Study design Hospital charts and outpatient records were reviewed for 12 consecutive patients undergoing central pancreatectomy from August 1999 to November 2002. Results We performed central pancreatectomy with pancreaticogastrostomy in 12 patients: 5 with serous cystadenomas, 6 with mucinous cystadenomas, and 1 with neuroendocrine tumor. All tumors were located in the body or neck of the pancreas, measuring a mean ± standard deviation (SD) of 2.5 ± 1.2 cm. Median postoperative hospital stay was 6.5 days (range 5 to 15 days). There were no intraoperative complications. Perioperative complications included two urinary tract infections and one readmission for acute pancreatitis. There were no pancreatic leaks or fistulas in this series. Two of the 12 patients experienced endocrine insufficiency with elevated glycosylated hemoglobin levels during outpatient followup. None of the 12 patients experienced exocrine insufficiency. Conclusions Central pancreatectomy with pancreaticogastrostomy reconstruction is safe and technically advantageous over Roux-en-Y pancreaticojejunostomy, and should be considered a safe reconstruction technique after central pancreatectomy for benign disease.",
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