Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cochrane on Reconstructing the Pancreatic Stump

Cochrane; 2017 Sep 12; Cheng, Briarava, et al

2 surgical options for reconstructing the pancreatic stump following pancreaticoduodenectomy offer similar results, according to a Cochrane review of 10 studies involving more than 1,600 individuals. Among the findings:

  • Pancreaticogastrostomy (PG) was not superior to pancreaticojejunostomy (PJ) in overall postoperative pancreatic fistula rate, hospital duration, or the need for surgical re-intervention.
  • 7 studies clearly distinguished clinically significant pancreatic fistula which required a change in the patient's management.
  • PJ probably has little or no difference from PG in rates of death or complications.
  • The risk of postoperative bleeding in participants undergoing PJ was slightly lower than those undergoing PG, but the risk of developing an abdominal abscess was higher.
  • Information about costs was not evaluated.

Cheng Y, Briarava M, Lai M, et al. Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy. Cochrane Database of Syst Rev. 2017, Issue 9. Art. No.: CD012257. doi:10.1002/14651858.CD012257.pub2.

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