Pancreaticojejunostomy and pancreaticogastrostomy are both used for reconstruction after pancreaticoduodenectomy; which method is best is still debated. A nationwide multicentre randomized clinical trial that compared these two types of reconstruction has demonstrated that pancreaticogastrostomy is associated with a substantially lower rate of clinically relevant postoperative pancreatic fistula than pancreaticojejunostomy.
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Fernández-Cruz, L. Pancreaticojejunostomy versus pancreaticogastrostomy. J. Hepatobiliary Pancreat. Sci. 18, 762–768 (2011).
Yeo, C. J. et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann. Surg. 222, 580–588 (1995).
Bassi, C. et al. Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study. Ann. Surg. 242, 767–771 (2005).
Duffas, J. P. et al. A controlled randomized multicenter trial of pancreatogastrostomy or pancreatojejunostomy after pancreatoduodenectomy. Am. J. Surg. 189, 720–729 (2005).
Fernández-Cruz, L., Cosa, R., Blanco, L., López-Boado, M. A. & Astudillo, E. Pancreatogastrostomy with gastric partition after pylorus-preserving pancreatoduodenectomy versus conventional pancreatojejunostomy: a prospective randomized study. Ann. Surg. 248, 930–938 (2008).
Topal, B. et al. Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial. Lancet Oncol. 14, 655–662 (2013).
Bassi, C. et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138, 8–13 (2005).
Dindo, D., Demartines, N. & Clavien, P. A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann. Surg. 240, 205–213 (2004).
Schmidt, C. M. et al. Effect of hospital volume, surgeon experience, and surgeon volume on patient outcomes after pancreaticoduodenectomy. A single-institution experience. Arch. Surg. 145, 634–640 (2010).
Pessaux, P. et al. Permeability and functionality of pancreaticogastrostomy after pancreaticoduodenectomy with dynamic magnetic resonance pancreatography after secretin stimulation. J. Am. Coll. Surg. 194, 454–462 (2002).
The authors declare no competing financial interests.
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Malleo, G., Bassi, C. Reconstruction methods after pancreaticoduodenectomy. Nat Rev Gastroenterol Hepatol 10, 445–446 (2013). https://doi.org/10.1038/nrgastro.2013.114
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