Comparison of pancreatogastrostomy and pancreatojejunostomy after pancreatoduodenectomy performed by one surgeon

Pancreatogastrostomy (PG) for restoring pancreaticoenteric continuity after pancreatoduodenectomy (PD) has been recommended by a few surgeons on the basis of certain theoretic and practical advantages of this procedure over pancreatojejunostomy (PJ). The purpose of this study was to determine whether PG can be a safe alternative to PJ. Eighty-six PDs performed by the same surgeon for periampullary carcinoma were analyzed to compare early and late postoperative results of PJ (n = 38) and PG (n = 48). The two groups were comparable for age, sex, diagnosis, stage, and operation time. PJ leakage developed in six patients (15.8%) and PG leakage in one (2.1%) (p < 0.05). Overall rates of morbidity/hospital mortality were 34.2/7.9% and 18.8/4.2% in the PJ and PG groups, respectively. In conclusion, PG showed a more favorable early outcome than PJ. PG is recommended for surgeons who encounter difficulties with PJ for reconstruction after PD.