Pancreaticogastrostomy (PG) Is Associated with a Higher Incidence of Grade C Postpancreatectomy Hemorrhage (PPH) Compared to Pancreaticojejunostomy (PJ): A Single-Center Prospective Cohort Study in 274 Patients

Introduction: PPH and postoperative pancreatic fistula (POPF) are the most life-threatening complications after pancreaticoduodenectomy (PD). The aim of this study is to compare incidence both between two reconstruction techniques: PG PJ. Method: 274 Patients undergoing PD were included in a prospective database. Dunking with interrupted sutures PDS 4/0 on rear side stomach was initially preffered technique because an expected lower risk at POPF. However large amount severe episodes changed dunking end-to-side PJ sutured 4/0. POPF definitions proposed by ISGPS used. Results: performed 30.7% patients, 69.3%. Late grade C bleeding more frequent (23.8%) than (5.3%) (p<0.001)(figure1). Because severity these bleedings , relaparotomy needed 77.4% 41.0% (p<0.001). Otherwise managed blood transfusion (17.0%), endoscopy (7.1%) or interventional angiography (18.6%). number patients soft remnant comparable for techniques, but cases duct > 3mm higher (p=0.02). No significant relationship found diameter, consistency use therapeutic range antitrombotics surgery. Conclusions: Compared PJ, associated significantly requiring relaparotomy. similar.Tabled 1EP02E-057 Table: Postpancreatectomy Hemorrhage PG/PJ Are factors (a) group?PatientcohortPPHPPH APPH BPPH CPOPF B/CPancreatic "soft" (a)Pancreatic "inflamed"Pancreatic "hard"Pancreatic >3mm (a)PG (n=84)38,1%8.3%7,1%23,8%14,30%43,20%11,90%42,90%45,30%PJ (n=190)21,6%7,9%8,4%5,3%11,60%42,40%7,90%48,90%60,00%p=0,0040,540,46<0,0010,330,490,200,210,02POPF (n=34)52,9%11.8%8,8%32,4%55,90%11,8%32,4%37,9%no (n= 240)23,3%7,5%7,9%7,9%40,60%8,80%49,20%58%p=<0,0010,500,53<0,0010,070,380,050.05Total (n=274)7429.7%29,7%40,6%3442.5%9,3%48,2%145 Open table new tab