Functional, biological, and radiological evaluation of the pancreaticojejunal anastomosis 1 year after pancreatoduodenectomy: a prospective study.
Langenbecks Arch Surg
; 408(1): 326, 2023 Aug 22.
Article
in En
| MEDLINE
| ID: mdl-37606699
ABSTRACT
PURPOSE:
This prospective study aimed to analyze the functional, biological, and radiological aspects of the pancreatic anastomosis 1 year after pancreatoduodenectomy (PD).METHODS:
From 2016 to 2019, patients with PD indication were screened. Questionnaires about pancreas insufficiency, fecal elastase tests, and magnetic resonance imaging (MRI) were performed before and 1 year after PD.RESULTS:
Twenty patients were prospectively included. The only difference between pre- and postoperative questionnaires was constipation (less frequent 1 year after PD). Median pre- and postoperative fecal elastase levels were 96 µg/g (IQR 15-196, normal value > 200) and 15 µg/g (IQR 15-26, p = 0.042). There were no significant differences in terms of main pancreatic duct (MPD) size (4, IQR 3-5 vs. 4 mm, IQR 3-5, p = 0.892), border regularity, stenosis, visibility, image improvement, and secondary pancreatic duct dilation before and after secretin injection. All patients but one (2 refused and 2 were lost to follow-up, 15/16, 94%) had a patent pancreaticojejunal anastomosis on 1-year MRI.CONCLUSION:
Although median 1-year fecal elastase was significantly lower than preoperatively, suggesting that exocrine secretion was altered, the anatomical outcome as assessed by MRI was excellent showing high patency rate (15/16, 94%) at 1 year. This emphasizes the difference between anatomy and function.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreaticojejunostomy
/
Pancreaticoduodenectomy
Type of study:
Diagnostic_studies
/
Observational_studies
Limits:
Humans
Language:
En
Journal:
Langenbecks Arch Surg
Year:
2023
Document type:
Article
Affiliation country:
Switzerland