Sutureless Pancreaticogastrostomy

Abstract

Aim: One of the most serious postoperative complications after pancreatoduodenectomy (PDE) is a postoperative pancreatic fistula (PF). This study presents a new technique of sutureless pancreaticogastrostomy (PGS).Materials and Methods: For the period December, 2012 - January, 2016 we peformed 59 sutureless PGS after a PDE (pylorus-preserving or Whipple). Pancreatic head adenocarcinoma is an indication of PDE.Results: The rate of postoperative mortality was 0%. The incidence of postoperative complications of grade I, II, III, IV according Dindo-Clavien classification reached 16.9% (n=10). Postoperative complications are PF grade A/B (n=4, 6.7%), delayed gastric emptying grade B/C (n=3,5.0%), and bleeding from the PGS (n=3, 5.0%) manifested clinically by melena and haematemesis.Conclusion: The sutureless PGS requires evaluation based on a larger series of patients. Initial results indicate that sutureless PGS has definite advantages over pancreaticojejunostomy affecting the lower frequency of insufficiency, due to the absence of transparenchymal stitches damaging the capsule and the parenchyma of the pancreas. The methodology is easy to implement and is particularly suitable for patients with a soft nonfibrotic pancreas.