Is circular-stapled gastrojejunostomy anastomosis apppropriate for pancreaticoduodenectomy?

Sevcan Alkan Kayaoğlu; Mehmet Ali Uzun; Doğan Erdoğan

doi:10.19161/etd.1371488

EN TR

Is circular-stapled gastrojejunostomy anastomosis apppropriate for pancreaticoduodenectomy?

Abstract

INTRODUCTION:Pancreaticoduodenectomy is a highly complex procedure that requires surgical experience.. Among these is the use of a stapler in the construction of the gastrojejunostomy anastomosis during the procedure. Our study compares the patient outcomes of gastrojejunostomy anastomosis procedures performed manually and with a circular stapler. MATERIALS AND METHOD:Our study retrospectively evaluated the data of 44 patients who had undergone pancreaticoduodenectomy performed by the same surgical team between May 2015 and December 2019. The manual gastrojejunostomy anastomosis(n = 32) and stapled (circular stapler 25 millimeter) anastomosis(n=12) patient groups were compared for anastomotic stricture. RESULTS:Of the 44 patients undergoing pancreaticoduodenectomy, 68.2% were male, the mean age was 62.9±12.1 years and the mean follow-up was 28.2±21.2 months. The rate of gastrojejunostomy stricture was significantly higher in the circular stapler group (p = 0.017;p < 0.05). CONCLUSION:The increased risk of postoperative pancreatic fistula and anastomotic stricture prevents us from recommending the use of a circular-stapler in the creation of the gastrojejunostomy anastomosis in pancreaticoduodenectomy procedures, as it increases the risk of postoperative pancreatic fistula and anastomotic stricture, and provides no operative time advantage.

Keywords

PANKREATİKODUODENEKTOMİ PROSEDÜRÜNDE GASTROJEJUNUOSTOMİ ANASTOMOZUNUN SİRKÜLER STAPLER İLE YAPILMASI ÖNERİLEBİLİR Mİ?

Öz

GİRİŞ:Pankreatikoduodenektomi, cerrahi deneyim gerektiren oldukça karmaşık bir işlemdir. İşlem sırasında gastrojejunostomi anastomozunun yapımında stapler kullanılması bunların arasında yer almaktadır. Çalışmamız elle ve sirküler stapler ile yapılan gastrojejunostomi anastomoz işlemlerinin hasta sonuçlarını karşılaştırmaktadır. GEREÇ VE YÖNTEM: Çalışmamızda Mayıs 2015 ile Aralık 2019 tarihleri arasında aynı cerrahi ekip tarafından pankreatikoduodenektomi yapılan 44 hastanın verileri geriye dönük olarak değerlendirildi. Gastrojejunostomi anastomozu el ile yapılan hasta grubu ile (n=32) ve anastomozu stapler (25 nolu sirküler stapler) ile yapılan hasta grubu(n=12) anastomoz darlığı açısından araştırıldı. BULGULAR:Pankreatikoduodenektomi yapılan 44 hastanın %68,2'si erkekti, yaş ortalaması 62,9±12,1 yıl ve ortalama takip süresi 28,2±21,2 aydı. Gastrojejunostomi darlığı oranı sirküler stapler grubunda anlamlı derecede yüksekti (p = 0,017;p < 0,05). SONUÇ: : Pankreatikoduodenektomi prosedüründe gastrojejunostomi anastomozunun sirküler stapler ile yapılmasını, postoperatif pankreas fistülü ve anastomoz darlığı riskini yükseltmesi, ayrıca operasyon süresi açısından da avantaj sağlamaması nedeniyle önermemekteyiz.

Anahtar Kelimeler

References

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Details

Primary Language

English

Subjects

General Surgery

Journal Section

Research Article

Authors

Sevcan Alkan Kayaoğlu ^*
0000-0002-3943-6616
Türkiye

Mehmet Ali Uzun
0000-0003-2823-6034
Türkiye

Doğan Erdoğan
0000-0002-3102-617X
Türkiye

Publication Date

September 9, 2024

Submission Date

October 4, 2023

Acceptance Date

February 12, 2024

Published in Issue

Year 2024 Volume: 63 Number: 3

DOI

https://doi.org/10.19161/etd.1371488

IZ

https://izlik.org/JA84KU78GH

Cite

RIS / Bibtex

Vancouver

1.Sevcan Alkan Kayaoğlu, Mehmet Ali Uzun, Doğan Erdoğan. Is circular-stapled gastrojejunostomy anastomosis apppropriate for pancreaticoduodenectomy? EJM. 2024 Sep. 1;63(3):356-61. doi:10.19161/etd.1371488