Effect of Modified Blumgart Anastomosis on Surgical Outcomes After Pancreaticoduodenectomy
Surgeons continue to be concerned about complications after pancreaticoduodenectomy, especially postoperative pancreatic fistula. Among the factors that cause postoperative pancreatic fistula, the pancreaticojejunostomy technique has stood out in recent studies. In this study, we aimed to compare th...
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| Veröffentlicht in: | The Turkish Journal of Gastroenterology 2022-02, Vol.33 (2), p.119-126 |
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| creator | Ozsay, Oguzhan Aydin, Mehmet Can |
| description | Surgeons continue to be concerned about complications after pancreaticoduodenectomy, especially postoperative pancreatic fistula. Among the factors that cause postoperative pancreatic fistula, the pancreaticojejunostomy technique has stood out in recent studies. In this study, we aimed to compare the surgical outcomes, especially POPF, of the modified Blumgart and the traditional anastomosis techniques in patients who underwent pancreaticoduodenectomy.
A total of 144 patients who underwent pancreaticoduodenectomy were divided into 2 groups according to the performed pancreaticojejunostomy technique (modified Blumgart anastomosis, n = 91 and traditional anastomosis, n = 53). Preoperative clinicodemographic data, perioperative findings, and postoperative results were compared between the groups. Additionally, factors associated with clinically relevant postoperative pancreatic fistula were analyzed.
The modified Blumgart anastomosis group had lower clinically relevant postoperative pancreatic fistula rate than traditional anastomosis group (n = 8 (8.8%) versus n = 14 (26.4%), P = .005). On the contrary, the biochemical leakage rate was higher in the modified Blumgart anastomosis group (n = 30 (33%) versus n = 9 (17%), P = .037). While postoperative pancreatic fistula-related reoperation rate was lower (n = 2 (2.2%) versus n = 7 (13.2%), P = .013), the length of hospital stay was also shorter (11 days (5-47 days) versus 21 days (6-46 days), P < .001) in the modified Blumgart anastomosis group. Univariate and multivariate analyses revealed that modified Blumgart anastomosis was an independent and negative predictive factor for clinically relevant postoperative pancreatic fistula (odds ratio = 0.274, 95% confidence interval = 0.103-0.728, P = .009).
Compared to the traditional anastomosis, modified Blumgart anastomosis decreases the rate of transition from biochemical leakage to clinically relevant postoperative pancreatic fistula and postoperative pancreatic fistula-related reoperation and also shortens the length of hospital stay. In addition, modified Blumgart anastomosis is an independent and negative predictive factor for the development of clinically relevant postoperative pancreatic fistula. |
| doi_str_mv | 10.5152/tjg.2021.21701 |
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A total of 144 patients who underwent pancreaticoduodenectomy were divided into 2 groups according to the performed pancreaticojejunostomy technique (modified Blumgart anastomosis, n = 91 and traditional anastomosis, n = 53). Preoperative clinicodemographic data, perioperative findings, and postoperative results were compared between the groups. Additionally, factors associated with clinically relevant postoperative pancreatic fistula were analyzed.
The modified Blumgart anastomosis group had lower clinically relevant postoperative pancreatic fistula rate than traditional anastomosis group (n = 8 (8.8%) versus n = 14 (26.4%), P = .005). On the contrary, the biochemical leakage rate was higher in the modified Blumgart anastomosis group (n = 30 (33%) versus n = 9 (17%), P = .037). While postoperative pancreatic fistula-related reoperation rate was lower (n = 2 (2.2%) versus n = 7 (13.2%), P = .013), the length of hospital stay was also shorter (11 days (5-47 days) versus 21 days (6-46 days), P < .001) in the modified Blumgart anastomosis group. Univariate and multivariate analyses revealed that modified Blumgart anastomosis was an independent and negative predictive factor for clinically relevant postoperative pancreatic fistula (odds ratio = 0.274, 95% confidence interval = 0.103-0.728, P = .009).
Compared to the traditional anastomosis, modified Blumgart anastomosis decreases the rate of transition from biochemical leakage to clinically relevant postoperative pancreatic fistula and postoperative pancreatic fistula-related reoperation and also shortens the length of hospital stay. In addition, modified Blumgart anastomosis is an independent and negative predictive factor for the development of clinically relevant postoperative pancreatic fistula.</description><identifier>ISSN: 1300-4948</identifier><identifier>EISSN: 2148-5607</identifier><identifier>DOI: 10.5152/tjg.2021.21701</identifier><identifier>PMID: 35238780</identifier><language>eng</language><publisher>Turkey: AVES</publisher><subject>Anastomosis ; Anastomosis, Surgical - adverse effects ; Anastomosis, Surgical - methods ; Care and treatment ; Comparative analysis ; Complications and side effects ; Fistula ; Humans ; Methods ; Original ; Pancreatic cancer ; Pancreatic Fistula - epidemiology ; Pancreatic Fistula - etiology ; Pancreatic Fistula - prevention & control ; Pancreaticoduodenectomy ; Pancreaticoduodenectomy - adverse effects ; Pancreaticoduodenectomy - methods ; Pancreaticojejunostomy - adverse effects ; Pancreaticojejunostomy - methods ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Risk factors ; Surgeons ; Surgical anastomosis ; Treatment Outcome</subject><ispartof>The Turkish Journal of Gastroenterology, 2022-02, Vol.33 (2), p.119-126</ispartof><rights>COPYRIGHT 2022 AVES</rights><rights>Copyright 2022 by The Turkish Society of Gastroenterology 2022 Turkish Society of Gastroenterology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c524t-2c6c12221c5f897423abc2a279682eda19e75a87ac46f116c874cb1d96ced1783</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128342/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128342/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35238780$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ozsay, Oguzhan</creatorcontrib><creatorcontrib>Aydin, Mehmet Can</creatorcontrib><creatorcontrib>Department of Gastrointestinal Surgery, Ondokuz Mayis University School of Medicine, Samsun, Turkey</creatorcontrib><title>Effect of Modified Blumgart Anastomosis on Surgical Outcomes After Pancreaticoduodenectomy</title><title>The Turkish Journal of Gastroenterology</title><addtitle>Turk J Gastroenterol</addtitle><description>Surgeons continue to be concerned about complications after pancreaticoduodenectomy, especially postoperative pancreatic fistula. Among the factors that cause postoperative pancreatic fistula, the pancreaticojejunostomy technique has stood out in recent studies. In this study, we aimed to compare the surgical outcomes, especially POPF, of the modified Blumgart and the traditional anastomosis techniques in patients who underwent pancreaticoduodenectomy.
A total of 144 patients who underwent pancreaticoduodenectomy were divided into 2 groups according to the performed pancreaticojejunostomy technique (modified Blumgart anastomosis, n = 91 and traditional anastomosis, n = 53). Preoperative clinicodemographic data, perioperative findings, and postoperative results were compared between the groups. Additionally, factors associated with clinically relevant postoperative pancreatic fistula were analyzed.
The modified Blumgart anastomosis group had lower clinically relevant postoperative pancreatic fistula rate than traditional anastomosis group (n = 8 (8.8%) versus n = 14 (26.4%), P = .005). On the contrary, the biochemical leakage rate was higher in the modified Blumgart anastomosis group (n = 30 (33%) versus n = 9 (17%), P = .037). While postoperative pancreatic fistula-related reoperation rate was lower (n = 2 (2.2%) versus n = 7 (13.2%), P = .013), the length of hospital stay was also shorter (11 days (5-47 days) versus 21 days (6-46 days), P < .001) in the modified Blumgart anastomosis group. Univariate and multivariate analyses revealed that modified Blumgart anastomosis was an independent and negative predictive factor for clinically relevant postoperative pancreatic fistula (odds ratio = 0.274, 95% confidence interval = 0.103-0.728, P = .009).
Compared to the traditional anastomosis, modified Blumgart anastomosis decreases the rate of transition from biochemical leakage to clinically relevant postoperative pancreatic fistula and postoperative pancreatic fistula-related reoperation and also shortens the length of hospital stay. In addition, modified Blumgart anastomosis is an independent and negative predictive factor for the development of clinically relevant postoperative pancreatic fistula.</description><subject>Anastomosis</subject><subject>Anastomosis, Surgical - adverse effects</subject><subject>Anastomosis, Surgical - methods</subject><subject>Care and treatment</subject><subject>Comparative analysis</subject><subject>Complications and side effects</subject><subject>Fistula</subject><subject>Humans</subject><subject>Methods</subject><subject>Original</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Fistula - epidemiology</subject><subject>Pancreatic Fistula - etiology</subject><subject>Pancreatic Fistula - prevention & control</subject><subject>Pancreaticoduodenectomy</subject><subject>Pancreaticoduodenectomy - adverse effects</subject><subject>Pancreaticoduodenectomy - methods</subject><subject>Pancreaticojejunostomy - adverse effects</subject><subject>Pancreaticojejunostomy - methods</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Risk factors</subject><subject>Surgeons</subject><subject>Surgical anastomosis</subject><subject>Treatment Outcome</subject><issn>1300-4948</issn><issn>2148-5607</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNks1rFTEUxYMo9vXp1qUMuHEzz9ybycdshNdSq1CpoG7chLxM8kyZmdQkI_S_N8_WouhCsggkv3Mu93AIeQZ0w4Hjq3K13yBF2CBICg_ICqFTLRdUPiQrYJS2Xd-pI3Kc8xWlTIHAx-SIcWRKKroiX868d7Y00Tfv4xB8cENzMi7T3qTSbGeTS5xiDrmJc_NxSftgzdhcLsXGyeVm64tLzQcz2-RMCTYOSxzcXA3jdPOEPPJmzO7p3b0mn9-cfTp9215cnr873V60lmNXWrTCAiKC5V71skNmdhYNyl4odIOB3klulDS2Ex5AWCU7u4OhF9YNIBVbk9e3vtfLbnKDdXNJZtTXKUwm3ehogv7zZw5f9T5-1z2gYnXemry8M0jx2-Jy0VPI1o2jmV1cskbBeCcZ1vzW5MUtujej02H2sTraA663oueyB8VFpTb_oOoZ3FRDmp0P9b0KBCAHUP8v-GuCTTHn5Pz9ukD1oRi6FkMfiqF_FqMKnv8e0j3-qwnsBx7us_Y</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Ozsay, Oguzhan</creator><creator>Aydin, Mehmet Can</creator><general>AVES</general><general>Turkish Society of Gastroenterology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220201</creationdate><title>Effect of Modified Blumgart Anastomosis on Surgical Outcomes After Pancreaticoduodenectomy</title><author>Ozsay, Oguzhan ; Aydin, Mehmet Can</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c524t-2c6c12221c5f897423abc2a279682eda19e75a87ac46f116c874cb1d96ced1783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anastomosis</topic><topic>Anastomosis, Surgical - adverse effects</topic><topic>Anastomosis, Surgical - methods</topic><topic>Care and treatment</topic><topic>Comparative analysis</topic><topic>Complications and side effects</topic><topic>Fistula</topic><topic>Humans</topic><topic>Methods</topic><topic>Original</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Fistula - epidemiology</topic><topic>Pancreatic Fistula - etiology</topic><topic>Pancreatic Fistula - prevention & control</topic><topic>Pancreaticoduodenectomy</topic><topic>Pancreaticoduodenectomy - adverse effects</topic><topic>Pancreaticoduodenectomy - methods</topic><topic>Pancreaticojejunostomy - adverse effects</topic><topic>Pancreaticojejunostomy - methods</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Risk factors</topic><topic>Surgeons</topic><topic>Surgical anastomosis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ozsay, Oguzhan</creatorcontrib><creatorcontrib>Aydin, Mehmet Can</creatorcontrib><creatorcontrib>Department of Gastrointestinal Surgery, Ondokuz Mayis University School of Medicine, Samsun, Turkey</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Turkish Journal of Gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ozsay, Oguzhan</au><au>Aydin, Mehmet Can</au><aucorp>Department of Gastrointestinal Surgery, Ondokuz Mayis University School of Medicine, Samsun, Turkey</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Modified Blumgart Anastomosis on Surgical Outcomes After Pancreaticoduodenectomy</atitle><jtitle>The Turkish Journal of Gastroenterology</jtitle><addtitle>Turk J Gastroenterol</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>33</volume><issue>2</issue><spage>119</spage><epage>126</epage><pages>119-126</pages><issn>1300-4948</issn><eissn>2148-5607</eissn><abstract>Surgeons continue to be concerned about complications after pancreaticoduodenectomy, especially postoperative pancreatic fistula. Among the factors that cause postoperative pancreatic fistula, the pancreaticojejunostomy technique has stood out in recent studies. In this study, we aimed to compare the surgical outcomes, especially POPF, of the modified Blumgart and the traditional anastomosis techniques in patients who underwent pancreaticoduodenectomy.
A total of 144 patients who underwent pancreaticoduodenectomy were divided into 2 groups according to the performed pancreaticojejunostomy technique (modified Blumgart anastomosis, n = 91 and traditional anastomosis, n = 53). Preoperative clinicodemographic data, perioperative findings, and postoperative results were compared between the groups. Additionally, factors associated with clinically relevant postoperative pancreatic fistula were analyzed.
The modified Blumgart anastomosis group had lower clinically relevant postoperative pancreatic fistula rate than traditional anastomosis group (n = 8 (8.8%) versus n = 14 (26.4%), P = .005). On the contrary, the biochemical leakage rate was higher in the modified Blumgart anastomosis group (n = 30 (33%) versus n = 9 (17%), P = .037). While postoperative pancreatic fistula-related reoperation rate was lower (n = 2 (2.2%) versus n = 7 (13.2%), P = .013), the length of hospital stay was also shorter (11 days (5-47 days) versus 21 days (6-46 days), P < .001) in the modified Blumgart anastomosis group. Univariate and multivariate analyses revealed that modified Blumgart anastomosis was an independent and negative predictive factor for clinically relevant postoperative pancreatic fistula (odds ratio = 0.274, 95% confidence interval = 0.103-0.728, P = .009).
Compared to the traditional anastomosis, modified Blumgart anastomosis decreases the rate of transition from biochemical leakage to clinically relevant postoperative pancreatic fistula and postoperative pancreatic fistula-related reoperation and also shortens the length of hospital stay. In addition, modified Blumgart anastomosis is an independent and negative predictive factor for the development of clinically relevant postoperative pancreatic fistula.</abstract><cop>Turkey</cop><pub>AVES</pub><pmid>35238780</pmid><doi>10.5152/tjg.2021.21701</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anastomosis Anastomosis, Surgical - adverse effects Anastomosis, Surgical - methods Care and treatment Comparative analysis Complications and side effects Fistula Humans Methods Original Pancreatic cancer Pancreatic Fistula - epidemiology Pancreatic Fistula - etiology Pancreatic Fistula - prevention & control Pancreaticoduodenectomy Pancreaticoduodenectomy - adverse effects Pancreaticoduodenectomy - methods Pancreaticojejunostomy - adverse effects Pancreaticojejunostomy - methods Postoperative Complications - etiology Postoperative Complications - surgery Risk factors Surgeons Surgical anastomosis Treatment Outcome |
| title | Effect of Modified Blumgart Anastomosis on Surgical Outcomes After Pancreaticoduodenectomy |
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