Retrograde vs Conventional Dissection Technique in Pancreaticoduodenectomy: A Pilot Study

JAMA Surg. 2014 Jun;149(6):604-7. doi: 10.1001/jamasurg.2013.3399.

Abstract

Importance: A retrograde dissection technique of pancreaticoduodenectomy in a caudocranial direction has been described recently.

Observations: Fifteen consecutive patients who underwent retrograde pancreaticoduodenectomy were compared with 15 consecutive patients operated on through a conventional approach. The mean (SD) intraoperative blood loss was 407 (202) mL in the retrograde group compared with 423 (253) mL in the conventional group (P = .84). The mean (SD) operative duration was 255 (57) minutes in the retrograde group compared with 264 (54) minutes in the conventional group (P = .66). The overall morbidity was 7 of 15 patients (47%) in the retrograde group and 6 of 15 (40%) in the conventional group (P > .99). Neither group had a positive resection margin or a perioperative death.

Conclusions and relevance: The retrograde dissection technique had no significant difference in perioperative outcomes compared with the conventional dissection technique and could serve as an alternative dissection approach in pancreaticoduodenectomy.

Publication types

  • Comparative Study

MeSH terms

  • Blood Loss, Surgical
  • Dissection / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreaticoduodenectomy / methods*
  • Pilot Projects
  • Postoperative Complications
  • Prospective Studies
  • Treatment Outcome