{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:26:23Z","timestamp":1781641583559,"version":"3.54.5"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2006,7,17]],"date-time":"2006-07-17T00:00:00Z","timestamp":1153094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,7,17]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pancreaticoduodenectomy is the primary treatment for periampullary cancer. Associated morbidity is high and often related to pancreatic anastomotic failure. This paper compares rates of pancreatic fistula, morbidity and mortality after pancreaticoduodenectomy in patients having reconstruction by pancreaticogastrostomy with those in patients having reconstruction by pancreaticojejunostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A meta-analysis was performed of all large cohort and randomized controlled trials carried out since 1990.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven articles were identified for inclusion: one prospective randomized trial, two non-randomized prospective trials and eight observational cohort studies. The meta-analysis revealed a higher rate of pancreatic fistula associated with pancreaticojejunostomy reconstruction (relative risk (RR) 2\u00b762 (95 per cent confidence interval (c.i.) 1\u00b791 to 3\u00b760)). A higher overall morbidity rate was also demonstrated in this group (RR 1\u00b743 (95 per cent c.i. 1\u00b726 to 1\u00b761)), as was a higher mortality rate (RR 2\u00b751 (95 per cent c.i. 1\u00b761 to 3\u00b791)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Current literature suggests that the safer means of pancreatic reconstruction after pancreaticoduodenectomy is pancreaticogastrostomy, but much of the evidence comes from observational cohort study data.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.5407","type":"journal-article","created":{"date-parts":[[2006,7,17]],"date-time":"2006-07-17T10:46:32Z","timestamp":1153133192000},"page":"929-936","source":"Crossref","is-referenced-by-count":163,"title":["Meta-analysis of pancreaticojejunostomy<i>versus<\/i>pancreaticogastrostomy reconstruction after pancreaticoduodenectomy"],"prefix":"10.1093","volume":"93","author":[{"given":"A","family":"McKay","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F R","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O F","family":"Bathe","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Doig","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Dort","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, Canada"},{"name":"Department of Community Health Sciences, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"C M","family":"Vollmer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Dixon","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2006,7,17]]},"reference":[{"key":"2021070910585771300_bib1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/00000658-199809000-00016","article-title":"Importance of hospital volume in the overall management of pancreatic cancer","volume":"228","author":"Sosa","year":"1998","journal-title":"Ann Surg"},{"key":"2021070910585771300_bib2","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/S0039-6060(96)80017-1","article-title":"Population-based analysis of treatment of pancreatic cancer and Whipple resection: Department of Defense hospitals, 1989\u20131994","volume":"120","author":"Wade","year":"1996","journal-title":"Surgery"},{"key":"2021070910585771300_bib3","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/S1091-255X(02)00432-8","article-title":"A comparison of pancreaticogastrostomy and pancreaticojejunostomy following pancreaticoduodenectomy","volume":"7","author":"Aranha","year":"2003","journal-title":"J Gastrointest Surg"},{"key":"2021070910585771300_bib4","first-page":"1831","article-title":"Pancreatic fistula and relative mortality in malignant disease after pancreaticoduodenectomy. 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