Blumgart's technique of pancreaticojejunostomy: Analysis of safety and outcomes.

Abstract

BACKGROUND:

Blumgart's pancreaticojejunostomy (PJ) has been described with low pancreatic leak rates. This study aimed to evaluate our experience with this technique regarding the pancreatic leak and other perioperative outcomes.

METHODS:

We performed a single-center retrospective analysis of a cohort of 81 patients who underwent pancreaticoduodenectomy in our department from January 2011 to February 2018. The primary endpoint was the occurrence of a clinically relevant postoperative pancreatic fistula (CR-POPF) and analysis of its risk factors.

RESULTS:

The CR-POPF rate was 12.3%. Fistula risk score (FRS) was the only significant risk factor for the occurrence of overall POPF in multivariate analysis. However, none of the other factors including FRS was found to be significantly associated with CR-POPF risk. A strong positive correlation was found between the CR-POPF and the incidence of delayed gastric emptying, post-pancreatectomy hemorrhage and increased length of hospital stay.

CONCLUSION:

Blumgart's technique is a safe technique of pancreatico-enteric anastomosis with low rates of CR-POPF. CR-POPF with this technique is independent of most of the preoperative and intraoperative factors. Therefore, this technique can be used for all types of the pancreas with consistently good results.

• Authors: Vishal Gupta, Saket Kumar, Vivek Gupta, Pradeep Joshi, Rahul Rahul, Rakesh Kumar Yadav, Amit Dangi, Abhijit Chandra
• Journal: Hepatobiliary & pancreatic diseases international : HBPD INT (Hepatobiliary Pancreat Dis Int) Vol. 18 Issue 2 Pg. 181-187 (Apr 2019) ISSN: 1499-3872 [Print] Singapore
• PMID: 30772208 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2019. Published by Elsevier B.V.

Topics

• Academic Medical Centers
• Adult
• Aged
• Analysis of Variance
• Anastomotic Leak (prevention & control)
• Blood Loss, Surgical (physiopathology)
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Operative Time
• Pancreatic Fistula (prevention & control)
• Pancreatic Neoplasms (pathology, surgery)
• Pancreaticoduodenectomy (adverse effects, methods)
• Pancreaticojejunostomy (adverse effects, methods)
• Patient Safety
• Retrospective Studies
• Risk Assessment
• Treatment Outcome