The aim of this study was to evaluate the place of pancreaticogastrostomy (PG) in reducing pancreaticfistula after pancreatoduodenectomy. From January 1988 to June 1991, 32 consecutive patients (meanage, 57 years) were operated on, 25 for malignant disease (78%). The pancreatic remnant was normal in17 patients (53%) and sclerotic in the others. There was one operative death (3.1%) unrelated to PG.Post-operative complications occurred in five patients (16%). Only two complications were related toPG: 1 patient had anastomotic intra-gastric bleeding and was reoperated on, 1 patient with a normalpancreatic remnant developed a pancreatic fistula (3.1%) treated conservatively.Reported series of PG, as well as our results, demonstrates that PG is associated with a dramaticdecrease of both pancreatic fistula and mortality rates. The risk of anastomotic haemorrhage can bereduced by preventative ligation of submucosal gastric vessels.In conclusion, PG appears as a simple and reliable method of management of the pancreatic remnantafter pancreatoduodenectomy.
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