To determine short-term outcomes following middle pancreatectomy with transgastric pancreaticogastric anastomosis.
Design, Setting, and Patients
A retrospective analysis of 23 patients who underwent middle pancreatectomy with transgastric pancreaticogastric anastomosis at the Massachusetts General Hospital, Boston, from June 22, 2005, through April 29, 2009.
Main Outcome Measures
Indications for procedure, operative time, length of stay, morbidity, mortality, and need for readmission, antibiotics, reoperation, additional procedures, or transfusion.
The mean age of 15 women and 8 men who underwent middle pancreatectomy with transgastric pancreaticogastric anastomosis was 55.0 years. The median follow-up time was 12.9 months. The most commonly resected tumors were intraductal papillary mucinous neoplasms (n = 9), serous cystadenomas (n = 5), and neuroendocrine tumors (n = 4). The mean (SD) operative time was 191 (39) minutes. No patients required intraoperative transfusion. The median hospital stay was 5 days. The most common complications were pancreatic fistula (n = 6), intra-abdominal abscess (n = 4), and superficial skin infection (n = 4). Three patients had splenic artery pseudoaneurysms. Seven patients required readmission; 2 required reoperation. No patients developed postoperative new or worsening endocrine or exocrine insufficiency. There were no deaths.
Middle pancreatectomy with transgastric pancreaticogastric anastomosis offers a safe alternative to the traditional Roux-en-y pancreaticojejunostomy and may be technically simpler.