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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 | Material characterization for the prediction of ductile fracture occurrence an inverse approach显示文摘 | FRATINI L LOMBARDO A MICARI F | 1996 | Journal of Materials Processing Technology1996，60，14： | 1 |
| 3 | Analysis of material formability in incremental forming显示文摘 | Filice L Fratini L Mieaxi F | 2002 | CIRP Annals - Manufacturing Technol- ogy2002，51，1： | 1 |
| 4 | Material flow in FSW of T-joints: experimental and numerical analysis 显示文摘 | BUFFA G FRATINI L MICARI F | 2008 | International Journal of Material Forming2008，1，1： | 1 |
| 5 | On the FSW of AA2024-T4 and AA7075-T6 T-joints: An industrial case study 显示文摘 | FRATINI L ACERRA F BUFFA G | 2010 | International Journal of Advanced Manufacturing Technology2010，48，9101112： | 1 |
| 6 | Molecular survey of Anaplasma phagocytophilum and Ehrlichia canisin red foxes ( Vulpes vulpes )from central Italy 显示文摘 | Ebani VV Verin R Fratini F | 2011 | J Wildl Dis2011，47，3： | 1 |
| 7 | On the material flow in FSW of T-joints: Influence of geometrical and technological parameters 显示文摘 | FRATINI L BUFFA G MICARI F | 2009 | International Journal of Advanced Manufacturing Technology2009，44，56： | 1 |
| 8 | The evaluation of spri ngback in 3D stamping and coining processes 显示文摘 | Focellese L Fratini F Gabrielli M F | 1998 | Journal of Materials Processing Technology1998，8081，： | 1 |
| 9 | On the use of SLS Tools in Sheet Metal Stamping显示文摘 | | 2003 | CIRP Annals2003，，1： | 1 |
| 10 | Pancreatectomy in multiple endocrine neoplasia type l-related gastrinonms and pancreatic endocrine neoplasiss显示文摘 | Tonelli F Fratini G Nesi G | 2006 | Ann surg2006，244，1： | 1 |
| 11 | On the FSW of AA2024-T4 and AA7075-T6 T-joints: An industrial case study 显示文摘 | Fratini L Acerra F Buffa G | 2010 | International Journal of Advanced Manufactu- ring Technology2010，48，9101112： | 1 |
| 12 | On the material flow in FSW of T-joints: Influence of geometrical and technological parameters显示文摘 | Fratini L Buffa G Micari F | 2009 | International Journal of Advanced Manufacturing Technology2009，44，56： | 1 |
| 13 | High-speed CW step-frequency coherent radar for dynamic monitoring of civil engineering structures显示文摘 | Pieraccini M Fratini M Parrini F | 2004 | Electronics Letters2004，40，14： | 1 |
| 14 | Optimal blankholder force path in sheet metal forming processes:an Al based procedure显示文摘 | Lorenzo R D Fratini L Micari F | 1999 | Annals of CIRP1999，48，1： | 1 |
| 15 | A simple experiment to characterize material formability in tube hydroforming显示文摘 | Filice L Fratini L Micari F | 2001 | CIRP Annals-Manufacturing Technology2001，，1： | 1 |
| 16 | High Coherent Radar for Dy namic Monitoring of Civil Engineering Structures 显示文摘 | Pieraccini M Fratini M Speed CW Step-Frequency Parrini F | 2004 | ElectronLett2004，40，14： | 1 |
| 17 | Mechanical and microstructural properties prediction by artificial neural networks in FSW processes of dual phase titanium alloys 显示文摘 | BUFFA G FRATINI L MICARI F | 2012 | Journal of Manufacturing Processes2012，14，3： | 1 |
| 18 | Tricalcium silicate hydra- tion reaction in the presence of comb-shaped superplasticizers: boundary nucleation and growth model applied to polymer-modi- fied pastes显示文摘 | RIDI F FRATINI E LUCIANI P | 2012 | Journal of Physical Chemistry C2012，116，10： | 1 |
| 19 | A new approach to study material bonding in extrusion porthole dies显示文摘 | Ceretti E Fratini L Gagliardi F | 2009 | CIRP Annals-Manuf Techn2009，58，1： | 1 |
| 20 | Pancreatectomy in multiple endocrine neoplasia type 1-related gastrinomas andpancreatic endocrine neoplasias 显示文摘 | Tonelli F Fratini G Nesi G | 2006 | Ann Surg2006，244，1： | 1 |
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