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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 | Total par- enteral nutrition alters molecular and cellular indices of intestinal inflammation in neonatal piglets 显示文摘 | Ganessunker D Gaskins H R Zuckermann F A | 1999 | J Parenter Enteral Nutr1999，23，6： | 1 |
| 3 | Myristoylation of the small en velope protein of porcine reproductive and respiratory syndrome virus is non-essential for virus infectivity but promotes its growth 显示文摘 | Du Y Zuckermann F A Yoo D | 2010 | Virus Research2010，147，2： | 1 |
| 4 | Systemic and mucosal immune responses to H1N1influenza virus infection in pigs显示文摘 | D L Larsena A Karasina F Zuckermann | 2000 | Veterinary Microbiology2000，74，： | 1 |
| 5 | Systemic and mu- cosal immune responses to H1NI influenza virus infection in pigs显示文摘 | Larsen D Karasin A Zuckermann F | 2000 | Veterinary Microbiology2000，74，： | 1 |
| 6 | Functional and phe- notypic analysis of porcine peripheral blood CD4/CD8 double-positive T cells显示文摘 | Zuckermann F A Husmann R J | 1996 | Immunology1996，87，： | 1 |
| 7 | Assessment of the efficacy of commercial porcine reproductive and respiratory syndrome virus (PRRSV) vaccines based on measurement of serologic response, frequency of gamma-IFN-producing cells and virological parameters of protection upon challenge 显示文摘 | Zuckermann F A Garcia E A Luque I D | 2007 | Vet Microbiol2007，123，13： | 1 |
| 8 | 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 |
| 9 | Complex between glycoproteins gI and gp63 of pseudorabies virus: its effect on virus replication显示文摘 | Zuckermann F A Thomas C | 1988 | J Virol1988，62，12： | 1 |
| 10 | 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 |
| 11 | Glyeoprotein gⅢ of pseudorahies virus is multifunctional 显示文摘 | Mettenleiter T C Zuckermann F | 1988 | J Virol1988，62，7： | 1 |
| 12 | Functional and phenotypic analysis of porcine peripheral blood CD4/CD8 double- positive T cells显示文摘 | Zuckermann F A Husmann R J | 1996 | Immunology1996，87，： | 1 |
| 13 | Antibody and cellu- lar immune responses of swine following immunization with plasmid DNA encoding the PRRS virus ORF' s 4,5,6 and 7 显示文摘 | KWANG J ZUCKERMANN F ROSS G | 1999 | Res Vet Sci1999，67，2： | 1 |
| 14 | Antibody and cellular immune responses of swine following immunization with plasmid DNA encoding the PRRS virus ORF's 4,5, 6 and 7 显示文摘 | Kwang J Zuckermann F Ross G | 1999 | Res Vet Sci1999，67，2： | 1 |
| 15 | Glycopro- tein gI of pseudorabies virus promotes cell fusion and virus spread via direct cell-to-cell transmission 显示文摘 | ZSAK L ZUCKERMANN F SUGG N | 1992 | J Virol1992，66，4： | 1 |
| 16 | Antibody and cellular immune responses of swine following immunization with plasmid DNA encoding the PRRS virus ORF's 4,5,6 and 7 显示文摘 | Kwang J Zuckermann F Ross G | 1999 | Res Vet Sci1999，67，2： | 1 |
| 17 | Antibody and cellular immune responses of swine following immunization with plasmid DNA encoding the PRRS virus ORFs4,5,6 and 7显示文摘 | Kwang J Zuckermann F Ross G | 1999 | VetSci1999，67，： | 1 |
| 18 | Myristoylation of the smallenvelope protein of porcine reproductive and respiratory syn-drome virus is non-essential for virus infectivity but promotesits growth显示文摘 | Du Y Zuckermann F A Yoo D | 2010 | Virus Res2010，147，2： | 1 |
| 19 | Role of pseudorabies virus glycoprotein gI in virus release from infected cells 显示文摘 | Mettenleiter T C Schreurs C Zuckermann F | 1987 | J Virol1987，61，9： | 1 |
| 20 | Immunologic responses and reproductive outcomes following exposure to wild-type or attenuated porcine reproductive and respiratory syndrome virus in swine under field conditions 显示文摘 | Lowe J F Zuckermann F A Firkins L D | 2006 | J Am Vet Med Assoe2006，228，7： | 1 |
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