Outcomes and Complications of Double Roux Loop Reconstruction in Pancreaticoduodenectomy: A Single Center Experience

Abstract

Background: pancreaticoduodenectomy is associated with higher morbidity and mortality rates. The leak of activated pancreatic enzymes can cause several complications which could be life threatening. One of the suggested methods, which can prevent complications, is double Roux anastomosis technique. Objectives: The aim of this study was to evaluate the outcomes and complications of double Roux anastomosis method. Methods: In this prospective study, patients who underwent pancreaticoduodenectomy with double Roux anastomosis were evaluated from 2013 to 2017. The outcomes and complications such as mortality rate, pancreatic leak or fistula, bile leakage, and abscess formation were evaluated. Results: A total of 12 patients were evaluated. The mean age was 53.08 ± 13.43 (19 - 70). Seven of them were male and five were female. Indications of surgery in the patients were periampullary cancer (6 patients), pancreatic head cancer (4 patients), distal cholangiocarcinoma (1 patient) and duodenal trauma (1 patient). There was no mortality, no pancreatic leak or fistula, no hemorrhage, and no abscess in any of the patient. There was one case of the biliary leakage, which was managed expectantly. Conclusions: The results of this study showed that use of separate double Roux, one for the pancreas and the other one for the stomach and bile duct reduces complications and mortality. Although this method requires more anastomosis and the operating time is prolonged, but ultimate outcome of the patient has great effects.