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Binding Pancreaticojejunostomy: Is It Safe?
Sanjay Gupta1, Ashok K Attri1, Rajeev Sharma1
1Department of Surgery, Government Medical College and Hospital, Chandigarh, India.
Insights
Peng's binding pancreaticojejunostomy (BPJ) is a safe technique for pancreaticoduodenectomy, showing a low incidence of postoperative pancreatic fistula (POPF). This study presents favorable outcomes with BPJ for managing pancreatic leaks.
Area of Science:
- Gastroenterology and Surgical Oncology
- Hepatobiliary and Pancreatic Surgery
Background:
- Postoperative pancreatic fistula (POPF) is a common complication after pancreaticoduodenectomy (PD), occurring in 5%-30% of cases.
- Current techniques to reduce POPF lack a definitive "gold standard" method.
- Peng's binding pancreaticojejunostomy (BPJ) has been proposed as a technique to lower POPF rates.
Purpose of the Study:
- To evaluate the safety and efficacy of Peng's binding pancreaticojejunostomy (BPJ) in reducing postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD).
Main Methods:
- Retrospective analysis of 24 patients who underwent PD with BPJ between January 2016 and March 2018.
- Data collected included demographics, clinical features, procedure type, complications (specifically POPF), hospital stay, morbidity, and mortality.
Main Results:
- The study included 24 patients (18 males, 6 females) with a mean age of 65.5 years.
- Ampullary carcinoma was the most frequent diagnosis (62.5%).
- The incidence of POPF was low at 8.33% (2 patients), with delayed gastric emptying being the most common complication (10 patients). One mortality was recorded.
Conclusions:
- Peng's binding pancreaticojejunostomy (BPJ) is a safe surgical technique.
- BPJ is associated with a low incidence of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD).
Background:
Postoperative pancreatic fistula (POPF) or leak from pancreaticojejunostomy (PJ) is one of the most common complications after pancreaticoduodenectomy (PD), with an incidence of 5%-30%. Various techniques have been advocated to bring down the incidence of POPF, but there is still none that can be called the "gold standard". Peng's binding PJ (BPJ) was proposed as a good method of performing PJ with low fistula rates; we present our results with BPJ.
Methods:
The data of all patients who underwent PD with BPJ between January 2016 and March 2018 were retrospectively analyzed for demographics, clinical features, type of procedure performed, complications (especially POPF), hospital stay, morbidity, and mortality.
Results:
A total of 24 patients (18 males and 6 females) were identified. The mean age at the diagnosis was 65.5 ± 6.4 years. Majority of the patients had ampullary carcinoma (62.5%). The most common postoperative complication was delayed gastric emptying seen in 10 patients, whereas only 2 (8.33%) had POPF and there was one mortality.
Conclusion:
BPJ is safe and is associated with a low incidence of POPF.
