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Comparison of Blumgart versus conventional 
duct-to-mucosa anastomosis for pancreaticojejunostomy 
after pancreaticoduodenectomy

Ann Hepatobiliary Pancreat Surg 2018 Aug;22(3):253-60
Published online August 31, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Yu-Ni Lee, Woo-Young Kim

Department of Surgery, Presbyterian Medical Center, Jeonju, Korea
Received January 13, 2018; Revised April 25, 2018; Accepted April 26, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Backgrounds/Aims: Pancreatic leakage is a major cause of postoperative death and morbidity after pancreaticoduodenectomy (PD). A recent study introduced Blumgart anastomosis (BA), which minimizes severe complications after PD. This study compares BA with conventional anastomosis (CA) for pancreaticojejunostomy (PJ) after PD at a single institution. 
Methods: A total of 87 patients who underwent PD at our hospital between January 2003 and October 2015 were enrolled in this study. The patients were divided into two groups according to the anastomosis type. Of them, 44 patients underwent anastomosis using CA (group A, conventional duct-to-mucosa anastomosis) and 43 underwent anastomosis using BA (group B, Blumgart anastomosis). 
Results: There was a significant difference in duration of the operation between groups A and B (473.1±102.0 versus 386.4±58.5 min, p<0.001) and intraoperative transfusion (2.2±2.7 versus 0.7±1.5 units, p<0.001). There was no significant difference between groups A and B in incidence of postoperative pancreatic fistula (POPF) (43.2% versus 27.9%, p=0.137) ,postoperative hemorrhage (PPH) (13.7% versus 7.0%, p=0.209), delayed gastric emptying (DGE) (29.5% versus 9.3%, p=0.063), surgical and non-surgical complications (60.5% versus 59.1%, p=0.896), length of ICU stay (9.0±6.3 versus 7.4±7.2 days, p=0.099), or length of postoperative hospital stay (37.7±16.7 versus 41.6±15.1 days, p=0.118). 
Conclusions: The results of this study suggest that BA-type PJ is not inferior to CA-type PJ in terms of postoperative complications.
Keywords : Pancreaticoduodenectomy; Pancreaticojejunostomy; Complication


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