An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture

Table 1 Preoperative and operative data

	New method	Conventional method	P
	n (%)	n (%)
Patient number	35	28
Male/female	20/15	11/17	0.77
Age (yr)	64.1 ± 9.2	68.0 ± 8.6	0.09
Preoperative biliary drainage	28 (80)	19 (68)	0.27
Diabetes mellitus	8 (23)	13 (46)	0.05
Weight loss > 10%	4 (11)	4 (14)	0.74
Operative indications			< 0.01
Biliary adenocarcinoma1	28 (80)	10 (36)
Ampullary adenocarcinoma	2 (6)	2 (7)
Duodenal adenocarcinoma	1 (3)	1 (4)
Pancreatic adenocarcinoma	0	12 (43)
Other pancreatic neoplasm2	4 (11)	3 (11)
Type of resection			0.44
Classical Whipple	6 (17)	7 (25)
Pylorus-preserving	29 (83)	21 (75)
Pancreaticojejunostomy	35 (100)	28 (100)	-
Diameter of pancreatic duct (mm)	2.4 ± 0.5	4.2 ± 1.9	< 0.01
Operative time (min)	392 ± 72	418 ± 110	0.24
Time after resection (min)	187 ± 56	181 ± 66	0.74
Blood loss (g)	1074 ± 490	1112 ± 607	0.78
Patients transfused	5 (14)	5 (18)	0.7

¹Carcinomas of the bile duct and the gallbladder;

²Non-invasive intraductal papillary-mucinous neoplasm, islet cell tumor, and lymphangiohemangioma of the pancreatic head.

Table 2 Postoperative course, complications and late outcome

	New method n (%)	Conventional method n (%)	P
Morbidity1	16 (46)	11 (39)	0.61
Abdominal complications	15 (43)	10 (36)	0.56
Pancreatic fistula
Definition A (Yeo et al)	1 (3)	2 (7)	0.43
Definition B (Park et al)	3 (8)	3 (8)	0.77
Definition C (Buchler et al)	6 (17)	3 (11)	0.47
Grade B or C by ISGPF definition	6 (17)	4 (14)	0.76
ISGPF definition
No fistula	20 (57)	21 (75)	0.23
Grade A	9 (26)	3 (11)
Grade B	6 (17)	3 (11)
Grade C	0	1 (4)
Biliary leakage	0	0	-
Intraabdominal abscess	2 (6)	4 (14)	0.25
Intraabdominal bleeding	0	0	-
Intestinal bleeding	0	1 (4)	0.26
Delayed gastric emptying	2 (6)	0	0.20
Liver abscess	0	1 (4)	0.26
Wound infection	2 (6)	0	0.20
Other complications	1 (3)	2 (7)	0.43
Pneumonia	0	1 (4)	0.26
Pulmonary embolism	0	1 (4)	0.26
Catheter fever	1 (3)	0	0.37
Re-operation	0	0	-
In-hospital mortality	0	0	-
Hospital stay (d)	29.5 ± 10.9	28.0 ± 12.2	0.60
Re-admission within 30 d	1 (3)	1 (4)	0.87
Late complications2
Progression of ductal dilatation	1 (3)	1 (4)	0.87
Exacerbation of diabetes	1 (3)	1 (4)	0.87
Body weight gain (%)3	100.3 ± 4.6	101.3 ± 9.0	0.65

¹Total patients with one or more complications;

²Comparison before hospital discharge and on the sixth month;

³Percent body weight gain at 6th month in comparison to that at the time of discharge.