Short- and long-term outcomes of choledochojejunostomy during pancreaticoduodenectomy and total pancreatectomy: interrupted suture versus continuous suture
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Choledochojejunostomy can be performed with either interrupted sutures (IS) or continuous sutures (CS). No reports have compared the short- or long-term patient outcomes resulting from these two methods.
A total of 228 consecutive patients who underwent pancreaticoduodenectomy or total pancreatectomy were prospectively enrolled in this study. All patients were alternately (by turns) assigned to the IS and CS groups. Among those patients, 161 patients who received regular postoperative follow-up for more than 2 years were eligible for analysis (IS group, n = 81; CS group, n = 80). A comparative analysis was performed between these groups regarding short-term (e.g., anastomotic leakage) and long-term complications (e.g., anastomotic stricture), time required to complete the anastomosis, and cost.
The incidence of anastomotic leakage and anastomotic stricture was comparable between the IS and CS groups (1.2% vs. 1.2%, p = 0.993; 8.6% vs. 6.2%, p = 0.563). The groups did not differ regarding the incidence of any short- or long-term complications. The time required to complete the anastomosis in the IS group was 27.0 ± 6.6 min, compared with 16.2 ± 5.0 min in the CS group (p < 0.001). The cost was $144.7 ± 34.6 in the IS group vs. $11.7 in the CS group (p < 0.001).
The IS and CS groups did not differ regarding short- and long-term outcomes. The anastomosis was completed in significantly less time in the CS group. The CS method was also superior in terms of cost.
KeywordsAnastomotic strictures Choledochojejunostomy Continuous sutures Interrupted sutures
The authors thank the member of Administrative Offices at the Department of Surgery, Osaka International Cancer Institute, for their unfailing enthusiasm and support to our program.
Authorship H.T., H. E.,H. O., M. S., and O. I. participated in study conception and design; T. T., H. T., H. A., S. K., A. T., K. G., H. E., and H. O. participated in acquisition of data; T. T., H. T., H. M., M. O., Y. F., and M. Y. participated in analysis and interpretation of data; T. T., H. T., and H. E. participated in drafting of manuscript; Y. Y., N. M., K. S., J.-H. M., T. O., and M. Y. participated in critical revision of manuscript.
The present study was partly financially supported by the grant of The Osaka Foundation for The Prevention of Cancer and Life-style Related Diseases for Hidenori Takahashi.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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