Pancreaticogastrostomy — An alternate for dealing with pancreatic remnant after pancreaticoduodenectomy — Experience from a tertiary care center of Pakistan

Whipple’s pancreaticoduodenectomy has been refined over the years to be a safe operation though the morbidity rate still remains high (30-50%). pancreatic fistula is the most important cause of mortality following pancreaticoduodenectomy. to prevent it,surgeons have used two anastomotic techniques: pancreaticojejunostomy and pancreaticogastrostomy. recent studies found that pancreaticogastrostomy is associated with fewer overall complications than pancreaticojejunostomy. this is a retrospective review of patients who underwent whipple’s at aga khan university hospital and had pancreaticogastrostomy as a preferred anastomosis for pancreatic stump. forty four patients met the inclusion criteria,27 were male. no patient developed post-operative pancreatic fistula,13 (31%) patients had morbidities including delayed gastric emptying 4(9.1%),wound infection 3(6.8%),and haemorrhage 6(13.6%). mortality is reported to be 5 (11.9%). pancreaticogastrostomy seems to be a safe alternative and easier anastomosis to perform with less post-operative morbidity and mortality. further data should become available with greater numbers in the future. © 2017,pakistan medical association. all rights reserved.