Pancreatogastrostomy versus pancreatojejunostomy for RECOnstruction after partial PANCreatoduodenectomy - A randomized controlled trial (RECOPANC)

• Applicant: Professor Dr. Tobias Keck
• Subject Area: General and Visceral Surgery
• Term: from 2011 to 2015
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 174118187

Tumors of the pancreatic head and chronic pancreatitis can be effectively treated by removal of the head of the pancreas and the duodenum. The pancreatic remnant has to be reconnected by suture either to the stomach (pancreatogastrostomy, PG) or to the small intestine (pancreatojejunostomy, PJ). This connection can be a challenge for the surgeon if the texture of the pancreatic gland is soft as this condition is especially associated with an increased risk of leakage of digestive juice from the pancreas, a “pancreatic fistula”. Patients are at risk for the development of serious complications like infection or bleeding if such leaking fluid starts to digest tissue in the abdominal cavity. Hospital stay is prolonged and health care costs are increased. It is unclear which of the two widely used methods (PG and PJ) for readapting the pancreas to the intestinal tract is associated with a lower risk for the development of pancreatic fistula. The hypothesis of this trial is that patients with a PG have a lower rate of clinically relevant pancreatic fistulas as compared to PJ, especially in high-risk patients with a soft pancreas. Patients are randomized to both techniques and observers and patients are kept blinded. As secondary endpoints, common problems of pancreatic surgery as well as the long-term outcome are assessed. The trial conduct is controlled by an independent institution to ensure patient safety and validity of data.

• DFG Programme: Clinical Trials
• Participating Person: Professor Dr. Ulrich T. Hopt