[Reconstruction following proximal pancreatoduodenectomy by simplified pancreatojejunal anastomosis. Operation results in 198 patients]. / Reconstrucción después de pancreatoduodenectomia proximal mediante anastomosis pancreatoyeyunal simplificada. Resultados operatorios en 198 pacientes.

INTRODUCTION: The pancreatojejunal anastomosis is considered the weak spot when carrying out a duodenopancreatectomy, because it causes most of the complications following a Whipple surgery. Here we present a series of cases using a single technique for performing this anastomosis. MATERIAL AND METHODS: During the period between October 2002 and August 2005, 49 duodenopancreatectomies were performed at the 3AII Department of the National Hospital Edgardo Rebagliati Martins (H.N.E.R.M.) in 31 of these cases a lateral mucosa to mucosa pancreatojejunal anastomosis was carried out by the same surgeon. RESULTS: The most frequent complication was infection of the operating wound followed by pancreatic fistula and intra-abdominal hemorrhage and the overall morbidity was 29%. Pancreatic fistula developed in 13% of the cases; however, no patient required additional treatment and the fistula closed maximum twenty days after the surgery. On average, patients resumed oral food intake after 6 days and remained hospitalized for 16 days. Mortality was 3%, because a patient developed a pseudo-aneurysm of the hepatic artery, which ruptured 17 days after the operation. CONCLUSIONS: The mucosa to mucosa pancreatojejunal anastomosis is a safe technique with a low index of pancreatic fistula and mortality.