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Geert Roeyen

Department of Hepatobiliary, Endocrine and Transplantation Surgery, Antwerp University Hospital, Belgium

Title: Pancreatic exocrine insufficiency after pancreaticoduodenectomy is more prevalent with pancreaticogastrostomy than with pancreaticojejunostomy. A retrospective multicenter observational cohort study

Biography

Biography: Geert Roeyen

Abstract

Objective:

Recently, pancreaticogastrostomy (PG) regained interest as reconstruction technique after pancreaticoduodenectomy (PD) because this technique might imply a lower risk of clinical pancreatic fistula than reconstruction by pancreaticojejunostomy (PJ). We hypothesize that PEI (pancreatic exocrine insufficiency) is more common during clinical follow up after PG than after PJ.

Research Design and Methods:

This study compares the prevalence of PEI in patients undergoing PD for malignancy reconstructed by PG versus reconstruction by PJ. PEI during the first year of follow up was defined as intake of pancreatic enzyme replacement therapy (PERT) within 1 year postoperatively and / or an abnormal exocrine function test.

Results:

In total 186 patients operated at 2 University Hospitals, were included. PEI during the first year postoperatively was present in 75.0% of the patients with PG compared with 45.7% with PJ (p<0.001). Intake of PERT within 1 year after surgery is more prevalent in the PG group: 75.8% versus 38.5% (p<0.001). There was a trend towards more disturbed exocrine function tests after PG (p=0.061). 

Conclusions:

PEI is more common with PG than with PJ reconstruction after pancreaticoduodenectomy for malignancy.