The mortality following pancreaticoduodenectomy has markedly decreased but remains an important\nchallenge for the complexity of operation and technical skills involved. The present study aimed to clarify the\nimpact of individualized pancreaticoenteric anastomosis and management to postoperative pancreatic fistula.\nMethods: Data from 529 consecutive pancreaticoduodenectomies were retrospectively analysed from the\nHepatobiliary and Pancreatic Surgery Unit I, Peking Cancer Hospital. The pancreaticoenteric anastomosis was\ndetermined based on the pancreatic texture and diameter of the main pancreatic duct. The amylase value of the\ndrainage fluid was dynamically monitored postoperatively on days 3, 5 and 7. A low speed intermittent irrigation\nwas performed in selected patients. Intraoperative and postoperative results were collected and compared between\nthe pancreaticogastrostomy (PG) group and pancreaticojejunostomy (PJ) group.\nResults: From 2010 to 2019, 529 consecutive patients underwent pancreaticoduodenectomy.\nPancreaticogastrostomy was performed in 364 patients; pancreaticojejunostomy was performed in 150 patients\nrespectively. The clinically relevant pancreatic fistula (CR-POPF) was 9.8% and mortality was zero. The soft pancreas,\ndiameter of main pancreatic.........................
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