Brief Article
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World J Gastroenterol. Jul 7, 2010; 16(25): 3178-3182
Published online Jul 7, 2010. doi: 10.3748/wjg.v16.i25.3178
Use of isolated Roux loop for pancreaticojejunostomy reconstruction after pancreaticoduodenectomy
Konstantinos Ballas, Nikolaos Symeonidis, Savvas Rafailidis, Theodoros Pavlidis, Georgios Marakis, Nikolaos Mavroudis, Athanasios Sakantamis
Konstantinos Ballas, Nikolaos Symeonidis, Savvas Rafailidis, Theodoros Pavlidis, Georgios Marakis, Nikolaos Mavroudis, Athanasios Sakantamis, Second Propedeutical Department of Surgery, Ippokratio General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos str, Thessaloniki, 54642, Thessaloniki, Greece
Author contributions: Ballas K and Symeonidis N designed the research and wrote the paper; Rafailidis S and Pavlidis T contributed to the analysis and interpretation of the data; Marakis G and Mavroudis N revised the article and Sakantamis A approved it for publication.
Correspondence to: Nikolaos Symeonidis, MD, PhD, Second Propedeutical Department of Surgery, Ippokratio General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos str, Thessaloniki, 54642, Thessaloniki, Greece. niksym@hotmail.com
Telephone: +30-2310-892181 Fax: +30-2310-992932
Received: March 19, 2010
Revised: April 12, 2010
Accepted: April 19, 2010
Published online: July 7, 2010
Abstract

AIM: To evaluate the efficacy of the isolated Roux loop technique in decreasing the frequency of pancreaticojejunal anastomosis failure.

METHODS: We retrospectively reviewed 88 consecutive patients who underwent pancreaticoduodenectomy (standard or pylorus-preserving). Single jejunal loop was used in 42 patients (SL group) while isolated Roux loop was used in 46 patients (RL group). Demographic characteristics (age, gender) and perioperative results (major/minor complications, mortality, hospital stay) were compared between the two groups.

RESULTS: Mortality was almost equal in both groups and overall mortality was 2.27%. Leak rate from the pancreaticojejunal anastomosis and hospital stay were lower in the RL group without significant difference. Morbidity was 39.1% in the RL group, insignificantly higher than the SL group. Operative time was almost 30 min longer in the RL group.

CONCLUSION: The isolated Roux loop, although an equally safe alternative, does not present advantages over the traditional use of a single jejunal loop. Randomized controlled studies are required to further clarify its efficacy.

Keywords: Pancreaticojejunal anastomosis, Isolated Roux loop, Whipple pancreaticoduodenectomy, Pancreatic leak