Pancreatico-Gastrostomy: A Modified Two-Layered Technique

Area of Science:

• Surgical Oncology
• Gastroenterology
• Abdominal Surgery

Background:

• Pancreato-duodenal resections are standard for periampullary carcinomas.
• Pancreato-enterostomy is crucial for surgical outcomes.
• Pancreato-jejunostomy (PJ) is common, but pancreato-gastrostomy (PG) is gaining renewed interest.

Purpose of the Study:

• To evaluate the safety and efficacy of a modified pancreato-gastrostomy (PG) technique.
• To assess leak rates and mortality associated with modified PG.
• To identify factors influencing the success of pancreatic anastomosis.

Main Methods:

• A modified pancreato-gastrostomy was performed on 100 periampullary carcinoma patients.
• Postoperative evaluation included drain fluid amylase and clinical assessment.
• Leaks were classified using the ISGPF criteria (biochemical, POPF B, POPF C).

Main Results:

• 80% of patients experienced no leaks.
• Biochemical leaks occurred in 10%, while POPF B and C were seen in 5% each.
• Mortality was 3%; pancreatic duct diameter >3mm and firm pancreas consistency were favorable factors.

Conclusions:

• Modified pancreato-gastrostomy is technically feasible and safe.
• The technique demonstrates low leak and mortality rates.
• Further studies with larger cohorts are needed to confirm efficacy.