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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 | Synthesis methods of fluorinated polyurethanes(1):Effects on thermal and dynamic-mechanical behaviours显示文摘 | Tonelli C Ajroldi G Turturro A | 2001 | Polymer2001，42，13： | 1 |
| 3 | Synthesis methods of fluorinated polyurethanes(2):Effects on morphology and microstructure显示文摘 | Tonelli C Ajroldi G Marigo A | 2001 | Polymer2001，42，24： | 1 |
| 4 | Determination of antibac- terial quaternary ammonium compound in lozenges and human serum by resonance light scattering technique 显示文摘 | Gagliardi L Cavazzutti G Tonelli D | 1998 | Analytical Letters1998，31，5： | 1 |
| 5 | New fluoro-modified thermoplastic polyurethanes显示文摘 | Tonelli C Ajroldi G | 2003 | Journal of Applied Polymer Science2003，87，14： | 1 |
| 6 | 显示文摘 | Tonelli C Ajroldi G | 2003 | J Appl Polym Sci2003，87，14： | 1 |
| 7 | Synthesis methods of fluorinated polyurethanes (2) : Effect on mor- phology and microstructure显示文摘 | TONELLI C AJROLDI G MARIGO A | 2001 | Polymer2001，42，24： | 1 |
| 8 | Relation between alkaline phosphatase, serum phosphate, and all-cause or cardiovascular mortality显示文摘 | Tonelli M Curhan G Pfeffer M | 2009 | Circulation2009，120，18： | 1 |
| 9 | New fluoro modified thermoplastic polyurethanes 显示文摘 | Tonelli ( Ajroldi G J | 2003 | Journal of Applied Polymer Science2003，87，14： | 1 |
| 10 | The influence of age on the flash visual evoked potentials显示文摘 | Contestabile MT Suppressa F Tonelli G | 1995 | Acta OphthalmolScand1995，73，4： | 1 |
| 11 | Relation between al- kaline phosphatase, serum phosphate, and all-cause or car- diovascular mortality 显示文摘 | Tonelli M Curhan G Pfeffer M | 2009 | Circulation2009，120，18： | 1 |
| 12 | Beclin 1 and autophagy are required for the tumorigenicity of breast cancer stem-like/ progenitor cells显示文摘 | Gong C Bauvy C Tonelli G | 2013 | Oncogene2013，32，18： | 1 |
| 13 | Advantages of spectrophotometric reading of ELISA plates for determination of the HBs/anti-HB system显示文摘 | Taliani G Palombo G Tonelli MG | 1981 | Boll Soc Ital Biol Sper1981，57，21： | 1 |
| 14 | Inhibition of the autophagic flux by salinomycin in breast cancer stemlike/progenitor cells interferes with their maintenance显示文摘 | Yue W Hamai A Tonelli G | 2013 | Autophagy2013，9，5： | 1 |
| 15 | Beclin 1 and autophagy are required for the tumorigenicity of breast cancer stern-like/progenitor ceils 显示文摘 | Gong C Bauvy C Tonelli G | 2013 | Oncogene2013，32，18： | 1 |
| 16 | Beclin 1 and autophagy are required for the tumorigenicity of breast cancer stem-like/progenitor cells显示文摘 | Gong C Bauvy C Tonelli G | 2013 | Oncogene2013，32，18： | 1 |
| 17 | New fluoro-nlodified thermoplastic polyurethanes 显示文摘 | TONELLI C AJROLDI G | 2003 | Journal of Applied Polymer Science2003，87，14： | 1 |
| 18 | Acta Ophthalmol Scandl显示文摘 | Contestabile MT Suppressa F Tonelli G The influence of age on the flash visual evoked potentiala | 1995 | Aug73{4):308-121995，734，： | 1 |
| 19 | Regulation of the CCAAT- binding NF-Y subunits in Arabidopsis thaliana显示文摘 | Gusmaroli G Tonelli C Mantovani R | 2001 | Gene2001，264，： | 1 |
| 20 | Beclin 1 and au- tophagy are required for the tumorigenicity of breast cancer stem-like/progenitor cells 显示文摘 | GONG C BAUVY C TONELLI G | 2013 | Oncogene2013，32，18： | 1 |
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