Duct-to-mucosa Versus Invagination for Pancreaticojejunostomy

Randomised Controlled Trail of Duct-to-mucosa Versus Invagination for Pancreaticojejunostomy After Pancreaticoduodenectomy

The purpose of this study is to determine whether duct-to-mucosa is better than invagination in pancreaticojejunostomy after pancreaticoduodenectomy. This single-centre, open, randomized controlled trail is conducted following ISGPF criteria for pancreatic fistula (PF). The duration of the study is supposed to start from Jan 5th 2012 and last to Dec 2014, until 100 or more cases are accessible. Patients diagnosed with pancreatic cancer, peri-ampullar carcinoma or other benign or malignant diseases which need to operate pancreaticoduodenectomy will be included. Main outcomes are pancreatic fistula rate, mortality, morbidity, reoperation and hospital stay. The investigators assumption that duct-to-mucosa is better than invagination.

Internal stent may be used during pancreaticojejunostomy according to the situation of pancreatic duct and experience of the surgeon.

The determine of pancreatic fistula follows the International Study Group on Pancreatic Fistulas (ISGPF) criteria.

From date of operation until the date of dischage or date of death from any cause, whichever came first,, assessed up to 200 days

30-day or in-hospital mortality: death from any cause within 30 days after operation or any in-hospital death are considered concerned with the type of pancreaticojejunostomy

From date of operation until the date of in-hospital death or death within 30 days after operation, whichever came first, assessed up to 200 days

From date of operation until the date of discharge or date of death from any cause, whichever came first, assessed up to 200 days

Reasons and times of reoperation are recorded. The attending doctor will decided Whether reoperation is needed, according to indications and his experience.

From date of operation until the date of discharge or date of death from any cause, whichever came first, assessed up to 200 days

From date of operation until the date of discharge or date of death from any cause, whichever came first, assessed up to 200 days

Inclusion Criteria: Patients diagnosed with pancreatic cancer or other diseases which need pancreaticoduodenectomy and pancreaticojejunostomy 18 to 80 y/o Operation-tolerated Informed consent Exclusion Criteria: History of gastrointestinal operation Pancreaticoduodenectomy is given up during operation Pancreatic duct is difficult to locate Patients require to exit from the study anytime

Bai X, Zhang Q, Gao S, Lou J, Li G, Zhang Y, Ma T, Zhang Y, Xu Y, Liang T. Duct-to-Mucosa vs Invagination for Pancreaticojejunostomy after Pancreaticoduodenectomy: A Prospective, Randomized Controlled Trial from a Single Surgeon. J Am Coll Surg. 2016 Jan;222(1):10-8. doi: 10.1016/j.jamcollsurg.2015.10.003. Epub 2015 Oct 21.