Abstract 336P
Background
Restoration of pancreatic continuity is the Achilles' heel of pancreaticoduodenectomy (PD). Postoperative pancreatic fistula (POPF) remains the most common complication and major cause of death after PD. Considering multiple techniques of anastomosis, no one technique is irrevocably better than the other. We establish a new anastomosis technique where pancreatic duct is kept longer and duct to mucosa anastomosis is done over a stent with minimal invagination into the jejunal mucosa. Subserosal jejunal sleeve is performed to increase the safety of our 5 layered anastomosis. We also assessed the effectiveness, safety and outcomes of this approach in our study.
Methods
Our study included 40 cases who received the new pancreatico-jejunostomy from January 2016 to November 2023.Data on the demographic characteristics, operative outcomes (total operative time, estimated blood loss) and postoperative results (length of hospital stay, Pancreatico jejunal leak, rates of postoperative 30-day morbidity and mortality) of the cases were prospectively collected and analyzed.
Results
Majority of the patients were belonging to age group of 60–70 years (40%) and 50-60 years (30%). In our study population 27 (67.5%) were males. The most common presenting symptom was abdominal pain (60%). The mean operation time was 424.63 min for Whipple’s procedure. Adenocarcinoma (80%) was the most common pathology. Postoperatively, the mean duration of hospital stay was 15 days. Most common post op complication noted was pneumonia (30%). Biochemical pancreatic leak in 4(10%) patients and POPF grade B – 1 (2.5%) and grade C – 2 (5%) was noted. POPF incidence of 7.5% was observed (ISGPS 2016). 3 patients required re-exploration for biliary leak and peri-pancreatic hematoma. 30 days post operative mortality was 5%.
Conclusions
Results demonstrate that this new technique is easy accomplished, safe and effective showing satisfactory outcomes especially at resulting in a lower POPF incidence. However larger multicentric trials are required to substantiate the results.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.