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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 | Cracks, bifurcation and shear bands propagation in saturated clays显示文摘 | Saada A S Bianchini G F Liang L Q | 1994 | Geotechnique1994，44，1： | 1 |
| 3 | Inside PageRank 显示文摘 | M Bianchini M Gori F Scarselli | 2005 | ACM Transactions on Internet Technology2005，5，1： | 1 |
| 4 | EphA2 reexpression prompts invasion of melanoma cells shifting from mesenchyrnal to amoeboid-like motility style显示文摘 | Parri M Taddei ML Bianchini F | 2009 | Cancer Res2009，69，5： | 1 |
| 5 | Real-Time Measurement System for Evaluation of the Carotid Intima-Media Thickness with a Robust Edge Operator显示文摘 | Faita F Gemignani V Bianchini E | 2008 | Journal of Ultrasound in Medicine2008，27，9： | 1 |
| 6 | Reciprocal activation of prostate cancer cells and cancer-associated fibroblasts stimulates epithelial-mesenchymal transition and cancer sternness 显示文摘 | Giannoni E Bianchini F Masieri L | 2010 | Cancer Res2010，70，69： | 1 |
| 7 | Weight control and physicalactivity in cancer prevention显示文摘 | Bianchini F Kaaks R Vainio H | 2002 | Obes Rev2002，3，1： | 1 |
| 8 | Cancer associated fibroblasts exploit reactive oxygen species through a proinflammatory signature leading to epithelial mesenchymal transition and sternness显示文摘 | Giannoni E Bianchini F Calorini L | | 0，，12： | 1 |
| 9 | Histone deacetylase-targeted treatment restores retinoic acid signaling and differentiation in acute myeloid leukemial显示文摘 | Ferrara F F Fazi F Bianchini A | 2001 | Cancer Res2001，61，1： | 1 |
| 10 | Mieroeolie turbines in the built environment: Influence of the installation site on the potential energy yield显示文摘 | Balduzzi F Bianchini A Ferrari L | 2012 | RenewableEnergy2012，45，： | 1 |
| 11 | Cancer as- sociated fibroblasts exploit reactive oxygen species through a proinflammatory signature leading to epithelial mesenchymal transition and stemness显示文摘 | GIANNONI E BIANCHINI F CALORINI L | 2011 | Antioxid Redox Signal2011，14，12： | 1 |
| 12 | Reciprocal activation of prostate cancer cells and cancer-associated fibroblasts stimulates epithelial-mesenchymal transition and cancer stemness显示文摘 | Giannoni E Bianchini F Masieri L | | 0，，17： | 1 |
| 13 | Stereochemical assign ment, antiinflammatory properties, and receptor for the omega-3 lipid mediator resolvin E1 显示文摘 | Arita M Bianchini F Aliberti J | 2005 | J Exp Med2005，201，5： | 1 |
| 14 | Reciprocal activation of prostate cancer cells and cancer-associated fibroblasts stimulates epithelial-mesenchymal transition and cancer stemness 显示文摘 | Giannoni E Bianchini F Masiefi L | 2010 | CancerRes2010，70，17： | 1 |
| 15 | Inside PageRank显示文摘 | BIANCHINI M GORI M SCARSELLI F | 2005 | ACM Trans on Internet Technology2005，5，1： | 1 |
| 16 | Allium vegetables and organosulfur compounds:do they help prevent cancer显示文摘 | BIANCHINI F VAINIO H | 2001 | Environmental Health Perspectives2001，109，9： | 1 |
| 17 | Expression of a metastatic phenotype in IFNs - primed/TNF αactivated B16 murine melanoma cells: role of JAK1/PKCd signal transduction factors显示文摘 | Bianchini F Mannini A Mugnai G | 2006 | Clin Exp Metastasis2006，23，34： | 1 |
| 18 | Highly effi- cient C--H insertion reactions of hydrogen peroxide cata- lyzed by homogeneous and heterogeneous methyltrioxorhe- nium systems in ionic liquids 显示文摘 | Bianchini G Crucianelli M de Angelis F | 2005 | Tetrahedron Lett2005，46，14： | 1 |
| 19 | Stereochemical assignment,antiinflammatory properties,and receptor for the omega-3 lipid mediator resolvin E1显示文摘 | BIANCHINI F ALIBERTI J | 2005 | J Exp Med2005，201，5： | 1 |
| 20 | Reciprocal activation of prostate cancer cells and cancer-associated fibroblasts stimulates epithelial-mesenehymal transition and cancer stemness显示文摘 | Giannoni E Bianchini F Masieri L | | 0，，17： | 1 |
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