The thickness of pancreatic transection line as a risk factor for postoperative pancreatic fistula after distal pancreatectomy using the stapler

s / Pancreatology 14 (2014) S1eS129 S114 Most commonly the tumours originated from the pancreatic head and thus we preferred to perform a pylorus-preserving pancreatoduodenectomy. Between 1998 and 2008 retrocolic duodeno/gastrojejunostomies were applied in 151 cases. Since 2008 the antecolic duodeno/gastrojejunostomy has been used in 123 cases for reconstruction completed with a Braun anastomosis between the afferent and efferent jejunal limb about 25 cm off the duodeno/gastrojejunostomy. Results: The differences were statistically not significant, regarding the postoperative hospitalization time, reoperation rate and operative mortality. Similarly the preand intraoperative data were statistically identical. However the frequency of DGE was significantly lower (2%) after antecolic recostruction, compared to that of the retrocolic group (10,6%, p: 0,040). Conclusion: It can be concluded that during pancreatoduodenectomy the antecolic reconstructionwith a Braun anastomosis is associatedwith an especially low occurrence of DGE. The presumed explanations are e besides other possible factors e the “straight” duodeno/gastrojejunostomy without angulation and the prevention of reflux of bile and pancreatic juice into the stomach.