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Updated: Jun 27, 2026
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Roux-en-Y reconstruction after pancreaticoduodenectomy
Stephen R Grobmyer1, Scott T Hollenbeck, David P Jaques
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
Hypothesis:
Roux-en-Y reconstruction (RYR) is associated with a reduction in morbidity and mortality associated with pancreatic anastomotic failure after pancreaticoduodenectomy compared with conventional loop reconstruction (CLR).
Design:
Retrospective study of patients from 1991 to 2006.
Setting:
Tertiary care center.
Patients:
Records of patients undergoing CLR (n = 588) and patients undergoing RYR (n = 112) between February 1, 1991, and June 30, 2006, for pancreatic ductal adenocarcinoma at a single institution were retrospectively reviewed and compared.
Main Outcome Measures:
Perioperative outcome and mortality were compared for patients who underwent RYR compared with those who underwent CLR.
Results:
Overall, both groups required a similar rate of postoperative interventional radiology procedures (CLR, 6.8%; RYR, 9.8%; P = .24) and subsequent operations (CLR, 6.9%; RYR, 9.1%; P = .62). No significant difference was found in the rate of overall postoperative mortality (CLR, 2.6%; RYR, 0.9%; P = .49). The overall rate of pancreatic anastomotic failure was 7.2%, and pancreatic anastomotic failure was associated with a 6% mortality rate. Among patients who developed pancreatic anastomotic failure, no significant difference was seen between CLR (n = 32) and RYR (n = 16) in length of hospital stay (18 vs 19 days; P = .98) or postoperative mortality (3 patients [9.4%] vs none [0%]; P = .54).
Conclusion:
We found that RYR is not associated with a reduction in morbidity after pancreaticoduodenectomy for pancreatic adenocarcinoma compared with CLR, even among patients who develop pancreatic anastomotic failure.
