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[Pancreaticogastrostomy: when and how?]

D Tittelbach-Helmrich1, T Keck2, U F Wellner3

  • 1DHBW Karlsruhe, Karlsruhe, Deutschland.

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
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Summary

Pancreaticogastrostomy, a newer technique for pancreatic reconstruction after pancreaticoduodenectomy, shows similar safety and complication rates to pancreaticojejunostomy. It is technically less demanding and suitable for minimally invasive approaches.

Keywords:
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Area of Science:

  • Surgical oncology
  • Gastrointestinal surgery
  • Pancreatic surgery

Background:

  • Pancreaticoduodenectomy requires reconstruction via pancreatic anastomosis.
  • Pancreaticogastrostomy and pancreaticojejunostomy are established techniques.
  • Pancreaticogastrostomy is less frequently performed but is a more recent method.

Purpose of the Study:

  • To present the history, techniques, and indications of pancreaticogastrostomy.
  • To compare pancreaticogastrostomy with pancreaticojejunostomy.

Main Methods:

  • Literature review.
  • Analysis of current evidence, including randomized controlled trials and meta-analyses.

Main Results:

  • No significant differences in complication rates between pancreaticogastrostomy and pancreaticojejunostomy.
  • Pancreatic function is comparable between the two techniques.
  • Pancreaticogastrostomy is technically less demanding.

Conclusions:

  • Pancreaticogastrostomy offers comparable safety to pancreaticojejunostomy.
  • Minimally invasive and parenchyma-sparing approaches expand applications for pancreaticogastrostomy.
  • Pancreaticogastrostomy is a viable alternative for pancreatic reconstruction.