Decreasing Morbidity of Pancreatic Fistula after Pancreaticoduodenectomy by Pair Watch Suturing Technique Duct to Mucosa Pancreaticojejunostomy (PWS-PJ)

Methods: Pair watch suturing technique duct to mucosa pancreaticojejunostomy (PWS-PJ) perform by absorbable-monofilament totally 12 stitches, start at 9 o'clock of pancreatic 3 jejunal side, 7 stitches posterior side and 5 anterior side. Post operative fistula was diagnosis using amylase activity on post day 7. Objectives: Investigated rate related complication conventional (C-PJ) PWS-PJ. Results: 86 Pancreaticoduodenectomy during Jan 2009 Dec 2019 were retrospective cohort analysis. 48 C-PJ performed from 2016 whereas 38 PWS-PJ started since 2017 2019. There is no significant different PF POD3 (C-PJ 26.9% (95%CI 9.9-43.9) while 31.6% 29.2-34)(P=0.689)) POD7 23.1% 7-39.2) 15.8% 4.3-27.3) (P=0.525)), Odd ratio 1.6 0.45-5.65). Base international study group surgery, lower grade B/C 27.1% (p=0.21),Odd 1.98 0.67-5.83). We reviewed that the multi-surgeons but has been done single surgeon more aggressive surgery cancer, most common location cancer ampulla 50%, Head pancreas 16.7% 23.7%, 55.3% (p=0.020), however, blood loss, hospital stay, death shown both anastomotic technique. Conclusions: Pancreatic relate reduced even radical cancer.