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| 1 | Comparison of Wirsung-jejunal duct-tomucosa and dunking technique for pancreatojejunostomy after pancreatoduodenectomy显示文摘Pancreato-enteric reconstruction after pancreatoduodenectomy (PD) is still a source of debate because of the high incidence of complications. Among the various types of pancreato-jejunostomies we don’t know yet which is the best in terms of anastomotic failure and related complications rates. Wirsung-jejunal duct-to-mucosa anastomosis (WJ) and 'dunking' pancreato-jejunal anastomosis (DPJ) are the two most used ones worldwide but conflicting results are reported. To determine which is the safer anastomosis and to define when an anastomosis should be preferred, we retrospectively reviewed two groups of patients who underwent WJ or DPJ. METHODS:Twenty-three patients underwent PD with WJ (n=17) with dilated (WJD) (n=9) or not-dilated Wirsung’s duct (WJND) (n=8) or with a DPJ (n=6) over a 3-year period at a single institution. RESULTS: The complications rate was high in all groups of patients (33.3% in WJD, 37.5% in WJND and 66.7% in DPJ). A pancreatic fistula developed in one patient in each group (11. 1% in WJD, 12. 5% in WJND and 16. 7% in DPJ). All these patients were managed conservatively. Anastomotic disruption took place in the WJ patients especially in the WJND group (n=2) compared to the WJD (n=1) (25% vs 11.1%) or DPJ groups (0%) : these three patients required a re-operation. Overall, the anastomotic defects were higher in patients who underwent WJND (37.5%), compared to WJD (22.2%) and to DPJ (16.7%). However, no statistical differences were found among the groups. Delayed gastric emptying (DGE) and total parenteral nutrition (TPN) along with anastomotic defects were responsible for a prolonged hospital stay. CONCLUSIONS:Our results were not able to demonstrate any statistical difference between the two different techniques in preventing anastomotic failure. WJ can represent a valid choice in case of a dilated duct and a firm, fibrotic enlarged gland that could not be properly invaginated in a small jejunal loop. DGE may occur in those patients who experienced an anastomotic failure and required a TPN regimen with a prolonged hospital stay. | Unita di Chirurgia, Dipartimento di Fisiopatologia Clinica (Batignani G, Fratini G, Zuckermann M and Tonelli F) and Dipartimento di Statistica (Bianchini E), Universitd degli Studi di Firenze, Flo rence, Italy | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，3： | 9 |
| 2 | Equivalence of Localized Spin Fluctuations and the Kondo-Nagaoka Spin- Compensated State显示文摘 | RIVER N ZUCKERMANN M J | 1968 | Physical Review Letters1968，21，13： | 1 |
| 3 | Immuological responses of swine to the PRRS virus infection 显示文摘 | Murtaugh M P Xiao Z Zuckermann F | 2002 | Viral Immunol2002，15，： | 1 |
| 4 | Immunological pespons- es of swine to porcine reproductive and respiratory syndrome virus infection 显示文摘 | MURTAUGH M P XIAO Z G ZUCKERMANN F | 2002 | Viral inununology2002，15，： | 1 |
| 5 | What's so special about cholesterol? 显示文摘 | Mouritsen O G Zuckermann M J | 2004 | Lipids2004，39，11： | 1 |
| 6 | Inferior approach for the isolation of the left-middle hepatic veins in liver resections显示文摘 | Batignani G Zuckermann M | 2005 | Arch Surg2005，140，10： | 1 |
| 7 | Immunological responses of swine to porcine reproductive and respiratory syndrome virus infection显示文摘 | Murtaugh M P Xiao Zheng-guo Zuckermann F | 2002 | Viral Immunol2002，15，： | 1 |
| 8 | Immunological responses of swine to porcine reproductive and respira- tory syndrome virus infection 显示文摘 | Murtaugh M P Xiao Z Zuckermann F | 2002 | Viral Immunol2002，15，4： | 1 |
| 9 | Is induction therapy still needed in heart transplantation? 显示文摘 | Aliabadi A Gr6mmer M Zuckermann A | 2011 | Curt Opin Organ Transplant2011，16，5： | 1 |
| 10 | Somatic CRISPR/Cas9-mediated tunour suppressor disruption enables versatile brain turnout mod- elling显示文摘 | ZUCKERMANN M HOVESTADT V KNOBBE-'fIOMS- EN C B | 2015 | Nat Commun2015，6，： | 1 |
| 11 | Improved long-term re- suits with ATG induction therapy after cardiac transplantation: a comparison of two different rabbit-antithymocyte globulines 显示文摘 | Zuckermann AO Grimm M Czerny M | 2000 | Transplantation2000，69，9： | 1 |
| 12 | Immunological responses of Swine to porcine reproductive and respiratory syndrome virus infection显示文摘 | MURTAUGH M P XIAO Z ZUCKERMANNS F | 2002 | Viral Immunol2002，15，： | 1 |
| 13 | Veno -occlusive disease as a complication of preoperative chemotherapy for Wilms tumor: A clinico - pathological analysis 显示文摘 | Jagt CT Zuckermann M Ten Kate F | 2009 | Pediatr Blood Cancer2009，53，7： | 1 |
| 14 | Weaning anorexia may contribute to local in flammation in the piglet small intestine显示文摘 | McCrachen B A Spurlock M E Roos M A Zuckermann F A andGaskins H R | 1999 | Journal of Nutrition1999，129，： | 1 |
| 15 | Immunologicalresponses of swine to porcine reproductive and re-spiratory syndrome virus infection显示文摘 | Murtaugh M P Xiao Z Zuckermann F | 2002 | Viral Immu-nol2002，15，： | 1 |
| 16 | Inferior approach for the isolation of the left - middle hepatic veins in liver resections 显示文摘 | Batignani G Zuckermann M | 2005 | Arch Surg2005，140，10： | 1 |
| 17 | Immunologicalresponses of swine to porcine reproductive and re-spiratory syndrome virus infection显示文摘 | Murtaugh M P Xiao Z Zuckermann F | 2002 | Viral Immu-nol2002，15，： | 1 |
| 18 | Immunolog- ical responses of swine to porcine reproductive and respiratory syndrome virus infection显示文摘 | Murtaugh M P Xiao P Z Zuckermann F | 2002 | Viral Immu- nol2002，15，： | 1 |
| 19 | Immunological responses of swine to porcine reproductive and respiratory syndrome virus infection 显示文摘 | MURTAUGH M P XIAO Z ZUCKERMANN F | 2002 | Viral Immunol2002，15，4： | 1 |
| 20 | Immunological responses of swine to porcine reproductive and respiratory syndrome virus infection显示文摘 | Murtaugh M P Xiao Z G Zuckermann F | 2002 | Viral Immunology2002，15，4： | 1 |
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