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Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial

Standard

Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial. / Keck, Tobias; Wellner, U F; Bahra, M; Klein, F; Sick, O; Niedergethmann, M; Wilhelm, T J; Farkas, S A; Börner, T; Bruns, C; Kleespies, A; Kleeff, J; Mihaljevic, A L; Uhl, W; Chromik, A; Fendrich, V; Heeger, K; Padberg, W; Hecker, A; Neumann, U P; Junge, K; Kalff, J C; Glowka, T R; Werner, J; Knebel, P; Piso, P; Mayr, M; Izbicki, J; Vashist, Y; Bronsert, P; Bruckner, T; Limprecht, R; Diener, M K; Rossion, I; Wegener, I; Hopt, U T.

in: ANN SURG, Jahrgang 263, Nr. 3, 04.12.2015, S. 440-9.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Keck, T, Wellner, UF, Bahra, M, Klein, F, Sick, O, Niedergethmann, M, Wilhelm, TJ, Farkas, SA, Börner, T, Bruns, C, Kleespies, A, Kleeff, J, Mihaljevic, AL, Uhl, W, Chromik, A, Fendrich, V, Heeger, K, Padberg, W, Hecker, A, Neumann, UP, Junge, K, Kalff, JC, Glowka, TR, Werner, J, Knebel, P, Piso, P, Mayr, M, Izbicki, J, Vashist, Y, Bronsert, P, Bruckner, T, Limprecht, R, Diener, MK, Rossion, I, Wegener, I & Hopt, UT 2015, 'Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial', ANN SURG, Jg. 263, Nr. 3, S. 440-9. https://doi.org/10.1097/SLA.0000000000001240

APA

Keck, T., Wellner, U. F., Bahra, M., Klein, F., Sick, O., Niedergethmann, M., Wilhelm, T. J., Farkas, S. A., Börner, T., Bruns, C., Kleespies, A., Kleeff, J., Mihaljevic, A. L., Uhl, W., Chromik, A., Fendrich, V., Heeger, K., Padberg, W., Hecker, A., ... Hopt, U. T. (2015). Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial. ANN SURG, 263(3), 440-9. https://doi.org/10.1097/SLA.0000000000001240

Vancouver

Keck T, Wellner UF, Bahra M, Klein F, Sick O, Niedergethmann M et al. Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial. ANN SURG. 2015 Dez 4;263(3):440-9. https://doi.org/10.1097/SLA.0000000000001240

Bibtex

@article{771830b541ef4faab33c186de5989287,
title = "Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial",
abstract = "OBJECTIVES: To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial.BACKGROUND: PJ and PG are established methods for reconstruction in pancreatoduodenectomy. Recent prospective trials suggest superiority of the PG regarding perioperative complications.METHODS: A multicenter prospective randomized controlled trial comparing PG with PJ was conducted involving 14 German high-volume academic centers for pancreatic surgery. The primary endpoint was clinically relevant postoperative pancreatic fistula. Secondary endpoints comprised perioperative outcome and pancreatic function and quality of life measured at 6 and 12 months of follow-up.RESULTS: From May 2011 to December 2012, 440 patients were randomized, and 320 were included in the intention-to-treat analysis. There was no significant difference in the rate of grade B/C fistula after PG versus PJ (20% vs 22%, P = 0.617). The overall incidence of grade B/C fistula was 21%, and the in-hospital mortality was 6%. Multivariate analysis of the primary endpoint disclosed soft pancreatic texture (odds ratio: 2.1, P = 0.016) as the only independent risk factor. Compared with PJ, PG was associated with an increased rate of grade A/B bleeding events, perioperative stroke, less enzyme supplementation at 6 months, and improved results in some quality of life parameters.CONCLUSIONS: The rate of grade B/C fistula after PG versus PJ was not different. There were more postoperative bleeding events with PG. Perioperative morbidity and mortality of pancreatoduodenectomy seem to be underestimated, even in the high-volume center setting.",
author = "Tobias Keck and Wellner, {U F} and M Bahra and F Klein and O Sick and M Niedergethmann and Wilhelm, {T J} and Farkas, {S A} and T B{\"o}rner and C Bruns and A Kleespies and J Kleeff and Mihaljevic, {A L} and W Uhl and A Chromik and V Fendrich and K Heeger and W Padberg and A Hecker and Neumann, {U P} and K Junge and Kalff, {J C} and Glowka, {T R} and J Werner and P Knebel and P Piso and M Mayr and J Izbicki and Y Vashist and P Bronsert and T Bruckner and R Limprecht and Diener, {M K} and I Rossion and I Wegener and Hopt, {U T}",
year = "2015",
month = dec,
day = "4",
doi = "10.1097/SLA.0000000000001240",
language = "English",
volume = "263",
pages = "440--9",
journal = "ANN SURG",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

RIS

TY - JOUR

T1 - Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial

AU - Keck, Tobias

AU - Wellner, U F

AU - Bahra, M

AU - Klein, F

AU - Sick, O

AU - Niedergethmann, M

AU - Wilhelm, T J

AU - Farkas, S A

AU - Börner, T

AU - Bruns, C

AU - Kleespies, A

AU - Kleeff, J

AU - Mihaljevic, A L

AU - Uhl, W

AU - Chromik, A

AU - Fendrich, V

AU - Heeger, K

AU - Padberg, W

AU - Hecker, A

AU - Neumann, U P

AU - Junge, K

AU - Kalff, J C

AU - Glowka, T R

AU - Werner, J

AU - Knebel, P

AU - Piso, P

AU - Mayr, M

AU - Izbicki, J

AU - Vashist, Y

AU - Bronsert, P

AU - Bruckner, T

AU - Limprecht, R

AU - Diener, M K

AU - Rossion, I

AU - Wegener, I

AU - Hopt, U T

PY - 2015/12/4

Y1 - 2015/12/4

N2 - OBJECTIVES: To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial.BACKGROUND: PJ and PG are established methods for reconstruction in pancreatoduodenectomy. Recent prospective trials suggest superiority of the PG regarding perioperative complications.METHODS: A multicenter prospective randomized controlled trial comparing PG with PJ was conducted involving 14 German high-volume academic centers for pancreatic surgery. The primary endpoint was clinically relevant postoperative pancreatic fistula. Secondary endpoints comprised perioperative outcome and pancreatic function and quality of life measured at 6 and 12 months of follow-up.RESULTS: From May 2011 to December 2012, 440 patients were randomized, and 320 were included in the intention-to-treat analysis. There was no significant difference in the rate of grade B/C fistula after PG versus PJ (20% vs 22%, P = 0.617). The overall incidence of grade B/C fistula was 21%, and the in-hospital mortality was 6%. Multivariate analysis of the primary endpoint disclosed soft pancreatic texture (odds ratio: 2.1, P = 0.016) as the only independent risk factor. Compared with PJ, PG was associated with an increased rate of grade A/B bleeding events, perioperative stroke, less enzyme supplementation at 6 months, and improved results in some quality of life parameters.CONCLUSIONS: The rate of grade B/C fistula after PG versus PJ was not different. There were more postoperative bleeding events with PG. Perioperative morbidity and mortality of pancreatoduodenectomy seem to be underestimated, even in the high-volume center setting.

AB - OBJECTIVES: To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial.BACKGROUND: PJ and PG are established methods for reconstruction in pancreatoduodenectomy. Recent prospective trials suggest superiority of the PG regarding perioperative complications.METHODS: A multicenter prospective randomized controlled trial comparing PG with PJ was conducted involving 14 German high-volume academic centers for pancreatic surgery. The primary endpoint was clinically relevant postoperative pancreatic fistula. Secondary endpoints comprised perioperative outcome and pancreatic function and quality of life measured at 6 and 12 months of follow-up.RESULTS: From May 2011 to December 2012, 440 patients were randomized, and 320 were included in the intention-to-treat analysis. There was no significant difference in the rate of grade B/C fistula after PG versus PJ (20% vs 22%, P = 0.617). The overall incidence of grade B/C fistula was 21%, and the in-hospital mortality was 6%. Multivariate analysis of the primary endpoint disclosed soft pancreatic texture (odds ratio: 2.1, P = 0.016) as the only independent risk factor. Compared with PJ, PG was associated with an increased rate of grade A/B bleeding events, perioperative stroke, less enzyme supplementation at 6 months, and improved results in some quality of life parameters.CONCLUSIONS: The rate of grade B/C fistula after PG versus PJ was not different. There were more postoperative bleeding events with PG. Perioperative morbidity and mortality of pancreatoduodenectomy seem to be underestimated, even in the high-volume center setting.

U2 - 10.1097/SLA.0000000000001240

DO - 10.1097/SLA.0000000000001240

M3 - SCORING: Journal article

C2 - 26135690

VL - 263

SP - 440

EP - 449

JO - ANN SURG

JF - ANN SURG

SN - 0003-4932

IS - 3

ER -