Pyloric-preserving Pancreaticoduodenectomy with Duct to Mucosa Pancreatico-gastrostomy Reconstruction: Long-term Follow-up in a Tertiary Center

Abstract

Background: Duct to mucosa Pancreatico-gastrostomy (DMPG) is a method for reconstruction of pancreatic mass following pancreaticoduodenectomy (PD). There are still controversies about the benefits of this surgical technique compared to the old ones. Objectives: This study aimed to evaluate the long-term outcomes of DMPG reconstruction following PD operation. Method: Through a prospective observational setting, 164 patients, undergoing PD surgery, with diagnosed pancreatic head or peri-ampullary cancer, were enrolled. A pylorus-preserving PD and DMPG were done for all patients to reconstruct the pancreatic mass. Patients were followed up to a mean of 21.06±14.12 months. Demographic data, risk factors, tumoral staging, and postoperative follow-up data were collected for the analytic study. Results: The mean survival of the patients was 21.06±14.23 months after surgery. DGE (delayed gastric emptying) (34.75%), pancreatic fistula (21.34%), bile duct fistula (7.31%), and hemorrhage (5.5%) were recorded as the most important complication in patients. Some post-operative complications were significantly observed in patients with diabetes mellitus (pancreatic fistula, increased amylase, and DGE), Smokers (bile duct fistula, hemorrhage, and increased Amylase), and the elders (bile duct fistula) (p-value 0.05). Conclusions: Although our results indicate that DMPG reconstruction is a safe technique, our findings did not confirm the priority of this method over the older techniques.