摘要：Introduction . Although in recent years there have been various versions of pancreatic - digestive reconstruction after cephalic duodenopancreatectomy, this issue is still highly debated. Purpose . This paper aims at comparing postoperative outcomes after gastric pancreatic anastomosis using transfixing threads as opposed to the purse-string suture method. Material and methods . Our study consisted of a lot of 15 patients that underwent cephalic duodenopancreatectomy from the 1th of May 2014 to the 30th of April 2015. The pancreatico - digestive reconstruction was done by pancreatico-gastric anastomosis using three different techniques: double purse-string suture used for the patients in the first group (group 1, n = 5 patients); one purse-string suture and 2 transfixing “U-sutures” passed through the stomach and the pancreas for the patients in the second group (group 2, n = 5 patients) and ductomucosa anastomosis with pancreatico-gastric transfixing threads in the third group (group 3, n = 5 patients). Results . Morbidity was 40% for the entire lot. Pancreatic fistula, occurred in two patients, one type A fistula in a patient in group 2 and one type B fistula in a patient in group 3. Biliary fistula occurred in one patient in group 2. Mortality was at 13.3%. The median time to carry out the anastomosis in group 1 was 14 minutes, for patients in group 2, 20 minutes, and for patients in group 3, 25 minutes. Conclusions . Gastric pancreatic anastomosis using purse-string sutures is a feasible, safe and fast process which reduces complications due to transfixing pancreatic threads.
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