From July, 1978 to April, 1995 91 pancreaticoduodenectomies were performed at the Department of Surgery, Hanyang University Hospital. We analysed the clinical aspects o them retrospectively and paid special attention to the type of
pancreaticojejunostomy. Among them, there were 33 cases of ampulla of Vater cancer, 19 cases of distal CBD cancer, 18 cases of pancreatic head cancer, 5 cases of chronic pancreatitis, 5 cases of trauma and injury, 4 cases of duodenal cancer, 2
cases of
pancreatic islet cell tumor, 1 case of pancreatic serous cystadenoma, 1 case of GB cancer that invaded the liver and distal CBD, 1 case of CHD cancer, and 1 case of duodenocolic fistula due to colon cancer.
@ES The results were as follows;
@EN The average age at operation was 51.8 years. The sex ratio of male to female was 1.6:1. In the operative procedures, the pancreaticojunustomies were performed with 49 end-to-end anastomoses, 26 end-to-side anastomoses without ductojejunostomy
(mucosa-to-mucosa) and 16 end-to-side anastomosed with ductojejunostomy. There were two leakages of the end-to-end pancreaticojejunostomy group and two leakages in the end-to-side ductojejunostomy group, but there was no significant statistical
difference.
There were four operative(hospital) mortality cases, definded as death within 30 days postop. The operative mortality rate was 4.4%. In the causes of death, there were two cases of acute myocardial infarction, one case of multiple organ failure,
and one
case of pulmonary complications. There were no operative mortality case related to the leakage of the pancreaticojejunostomy.
We conclude that the type of pancreaticojejunostomy does not influence the leakage of pancreaticojejunostomy, postoperative morbidity or operative mortality. We also suggest that the experience of the pancreatic surgenon and the surgical team
play
an
important role in decreasing the operative mortality and complications of the pancreaticoduodenectomy.
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