OBJECTIVES: The postoperative pancreatic fistula (POPF) is a major complication after pancreatic head resection whereby the technique of the anastomosis is a very influencing factor. The literature describes a possible protective role of the Blumgart anastomosis. METHODS: Patients after pancreatic head resection with reconstruction through the modified Blumgart anastomosis (a 2 row pancreatic anastomosis through mattress sutures of the parenchyma and duct to mucosa pancreaticojejunostomy, Blumgart-group) were compared with patients after pancreatic head resection and reconstruction through the conventional pancreatojejunostomy (single suture technique of capsule and parenchyma to seromuscularis, PJ-group). The Data were collected retrospectively. Depending on the propensity score matching in a ratio of 1:2 comparison groups were set up. Blumgart-group (n=29) and PJ-group (n=56). The primary end point was the rate of POPF. Secondary goals were duration of operation, length of hospital stay, length of stay on intermediate care units and hospital mortality. RESULTS: The rate of POPF (biochemical leak, POPF "grade B" and POPF "grade C") was less in the Blumgart-group, but without statistical relevance (p=0.23). Significantly less was the rate of POPF "grade C" in the Blumgart-group (p=0.03). Regarding the duration of hospital stay, length of stay on intermediate care units and hospital mortality, there was no relevant statistical difference between the groups (p=0.1; p=0.4; p=0.7). The duration of the operation was significantly less in the Blumgart-group (p=0.001). CONCLUSIONS: The modified Blumgart anastomosis technique may have the potential to decrease major postoperative pancreatic fistula.
OBJECTIVES: The postoperative pancreatic fistula (POPF) is a major complication after pancreatic head resection whereby the technique of the anastomosis is a very influencing factor. The literature describes a possible protective role of the Blumgart anastomosis. METHODS: Patients after pancreatic head resection with reconstruction through the modified Blumgart anastomosis (a 2 row pancreatic anastomosis through mattress sutures of the parenchyma and duct to mucosa pancreaticojejunostomy, Blumgart-group) were compared with patients after pancreatic head resection and reconstruction through the conventional pancreatojejunostomy (single suture technique of capsule and parenchyma to seromuscularis, PJ-group). The Data were collected retrospectively. Depending on the propensity score matching in a ratio of 1:2 comparison groups were set up. Blumgart-group (n=29) and PJ-group (n=56). The primary end point was the rate of POPF. Secondary goals were duration of operation, length of hospital stay, length of stay on intermediate care units and hospital mortality. RESULTS: The rate of POPF (biochemical leak, POPF "grade B" and POPF "grade C") was less in the Blumgart-group, but without statistical relevance (p=0.23). Significantly less was the rate of POPF "grade C" in the Blumgart-group (p=0.03). Regarding the duration of hospital stay, length of stay on intermediate care units and hospital mortality, there was no relevant statistical difference between the groups (p=0.1; p=0.4; p=0.7). The duration of the operation was significantly less in the Blumgart-group (p=0.001). CONCLUSIONS: The modified Blumgart anastomosis technique may have the potential to decrease major postoperative pancreatic fistula.
Authors: Claudio Bassi; Massimo Falconi; Enrico Molinari; William Mantovani; Giovanni Butturini; Andrew A Gumbs; Roberto Salvia; Paolo Pederzoli Journal: Surgery Date: 2003-11 Impact factor: 3.982
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Authors: Tobias Keck; U F Wellner; M Bahra; F Klein; O Sick; M Niedergethmann; T J Wilhelm; S A Farkas; T Börner; C Bruns; A Kleespies; J Kleeff; A L Mihaljevic; W Uhl; A Chromik; V Fendrich; K Heeger; W Padberg; A Hecker; U P Neumann; K Junge; J C Kalff; T R Glowka; J Werner; P Knebel; P Piso; M Mayr; J Izbicki; Y Vashist; P Bronsert; T Bruckner; R Limprecht; M K Diener; I Rossion; I Wegener; U T Hopt Journal: Ann Surg Date: 2016-03 Impact factor: 12.969
Authors: Christopher M Halloran; Kellie Platt; Abbie Gerard; Fotis Polydoros; Derek A O'Reilly; Dhanwant Gomez; Andrew Smith; John P Neoptolemos; Zahir Soonwalla; Mark Taylor; Jane M Blazeby; Paula Ghaneh Journal: Trials Date: 2016-01-15 Impact factor: 2.279