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Pancreaticogastrostomy as a Beneficial Alternative to a Pancreaticojejunostomy

Other Title
췌위장문합술이 췌공장문합술의 대안으로 가능한가?
Authors
김, 욱환
Citation
Korean journal of hepato-biliary-pancreatic surgery, 11(1):19-26, 2007
Journal Title
Korean journal of hepato-biliary-pancreatic surgery
ISSN
1738-63492288-9213
Abstract
Pancreaticogastrostomy (PG) has been used as an alternative procedure for pancreaticojejunostomy (PJ) for reconstruction after a pancreaticoduodenectomy (PD). Leakage at the pancreatoenteric anastomosis is still a major cause of morbidity and mortality after a PD. Therefore the major goal of technical modifications should be elimination or at least a reduction of pancreatic leakage. A number of published studies have shown that PG is associated with a low rate of anastomotic leakage. PG is easier to perform due to the thick posterior wall of the stomach and its excellent blood supply being proximal to the remaining pancreas. Furthermore, the pancreatic juice appears to be neutralized by the gastric juice, resulting in a reduction in the morbidity and mortality associated with anastomotic leakage. PG also results in a straight alignment of the digestive tract without an A-loop. PG and PJ showed an impaired exocrine and endocrine pancreatic function with a similar extent. The activity of the pancreatic enzymes is inhibited in the stomach after a PG. The enzymes become activated when gastric pH exceeds 3.1, which normally occurs after the ingestion of a meal. In conclusion, we recommend duct-to-mucosa PG as a beneficial alternative to a PJ, even in the hands of an inexperienced surgeon.
Keywords
췌위장문합술췌장누공췌장기능PancreaticogastrostomyPancreatic leakagePancreatic fucntion
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Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
AJOU Authors
김, 욱환
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