The effects of the end-to-side inverted mattress XXXX : a single surgeon's experience.

@entity1 @entity295 @entity943 @entity1157 @entity3472 @entity204
PURPOSE: Various pancreaticojejunostomy (PJ) techniques have been devised to minimize the rate of postoperative @entity3472 (POPF) after pancreatoduodenectomy (PD). This study describes a modification of the mattress suture PJ technique, which we call "inverted mattress PJ (IM)". The results of an IM group and a historical consecutive control group were compared to determine how the IM technique affected POPF. METHODS: From 2003 to 2010, 186 consecutive @entity1 underwent PD. A former group of 52 consecutive @entity1 who underwent conventional @entity1157 ( @entity1157 ) was used as a historical control group. The IM technique was utilized for the IM group (134 @entity1 ). The clinicopathological features and surgical outcomes of the 2 groups were compared, with a particular focus on postoperative POPFs. RESULTS: The average surgery duration was shorter in the IM group (580.3 minutes vs. 471 minutes, P < 0.001). Grades B and C POPFs occurred less frequently in the IM group, but the difference was not statistically significant (17.3% vs. 9.7%, P = 0.200). However, no grade C POPF occurred in the IM group compared with 5.8% of grade C POPFs (3/52) in the @entity1157 group (P = 0.020). Three @entity1 died (1 in the @entity1157 group and 2 in the IM group). The causes of @entity204 were @entity943 in 2 cases and @entity295 in 1 case. POPF was not causally related to the 3 deaths. CONCLUSION: IM end-to-side PJ shortened operation time and increased safety with no incidence of grade C POPF.
