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Improvement of pancreaticojejunostomy in pancreatoduodenectomy.

We compared two methods of pancreaticojejunostomy in 36 patients undergoing pancreatoduodenectomy. Pancreatoduodenectomy was performed in 17 men and 19 women aged 35-81 years, including 20 with pancreatic head cancer and 11 with papilla of Vater cancer. Group A (n = 19) underwent pancreaticojejunostomy with a stent tube that was exteriorized via the jejunum. In group B (n = 17), the stent tube ran transhepatically from the pancreatic duct before being exteriorized. The operating time, volume of pancreatic secretions, and time until stent removal were not significantly different between the two groups. However, there were 3 deaths related to early anastomotic leakage and 1 pancreatic fistula in group A, while group B had only 2 spontaneously healing pancreatic fistulas. Our results suggested that the pancreaticojejunostomy method used for group B is superior due to its simplicity, shorter operating time, and better outcome.