Pancreaticojejunostomy Stricture After Pancreatoduodenectomy: Outcomes After Operative Revision

Jessica L. Cioffi, Lucas A. McDuffie, Alexandra M. Roch, Nicholas Zyromski, Eugene P. Ceppa, C. Schmidt, Attila Nakeeb, Michael House

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Introduction: The natural history of radiographic strictures of the pancreaticojejunostomy (PJ) after pancreatoduodenectomy (PD) is difficult to characterize. The purpose of this study was to identify the indications for operative revision of PJ strictures after PD for benign and malignant disease and to evaluate its safety and clinical efficacy. Methods: A retrospective review of all patients undergoing operative revision of PJ strictures following PD at a single academic institution over an 8-year period (2006–2014) was performed. Results: Twenty-seven patients underwent revision of a symptomatic radiographically detectable PJ stricture. The median time from PD to PJ stricture diagnosis was 46 months. The median increase in the main pancreatic duct diameter between the time of PD and PJ revision was 2 mm. The overall morbidity after PJ revision was 26 %. No postoperative mortality occurred. Twenty-one (78 %) patients experienced resolution of symptoms without recurrent acute pancreatitis after PJ revision during a median follow-up of 30 months. Durable symptom resolution was reported among 60 % of patients with chronic pancreatitis. Conclusions: Surgical revision of pancreaticojejunostomy strictures is technically safe and clinically effective for selected patients who experience recurrent acute pancreatitis after pancreatoduodenectomy for either benign or malignant disease.

Original languageEnglish (US)
Pages (from-to)293-299
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume20
Issue number2
DOIs
StatePublished - Feb 1 2016

Keywords

  • Pancreaticojejunostomy revision
  • Pancreaticojejunostomy stricture
  • Pancreatoduodenectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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