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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 | On the influence of tool path in friction stir spot welding of aluminum alloys显示文摘 | Buffa G Fratini L Piacentini M | 2008 | Journal of Materials Processing Technology2008，208，13： | 1 |
| 3 | On microstructural phenomena occurring in friction stir welding of aluminium alloys 显示文摘 | BARCELLONA A BUFFA G FRATINI L PALMERI D | 2006 | J Mater Processing Technology2006，177，： | 1 |
| 4 | FEM based prediction of phase transformations during friction stir welding of Ti6A14V titanium alloy显示文摘 | BUFFA G DUCATO A FRATINI L | 2013 | Materials Science and Engineering: A2013，581，： | 1 |
| 5 | Volatile profile of Atlantic shellfish species by HS- SPME GC/MS 显示文摘 | Fratini G Lois S Pazos M | 2012 | Food Research International2012，48，2： | 1 |
| 6 | Development of emulsion from biomass pyrolysis liquid and diesel and their use in engines: Part 1 Emulsion production 显示文摘 | CHIARAMONTI D BONINI M FRATINI E TONDI G GARTNER K BRIDGWATER A V GRIMM H P SOLDAINI I WEBSTER A BAGLIONI P | 2003 | Biomass Bioenergy2003，25，1： | 1 |
| 7 | Volatile profile of Atlantic shellfish species by HS-SPME GC/MS显示文摘 | FRATINI G LOIS S PAZOS M | 2012 | Food Research Internat Ional2012，48，2： | 1 |
| 8 | Volatile profile of atlantic shellfish species by HS-SPME GC/MS 显示文摘 | Fratini G Lois S Pazos M | 2012 | Food Research International2012，48，2： | 1 |
| 9 | Frictionstir welding of lap joints: Influence of process parameterson the metallurgical and mechanical properties 显示文摘 | BUFFA G CAMPANILE G FRATINI L | 2009 | Materials Science and Engineering A2009，519，12： | 1 |
| 10 | Friction stir welding of AA6082-T6 T-joints: Process engineering and performance measurement 显示文摘 | FRATINI L BUFFA G FILICE L | 2006 | Proceedings of the Institution of Mechanical Engineers Part B-Journal of Engineering Manufacture2006，220，： | 1 |
| 11 | Sequence, expression, and evolutionary conservation of a gene encoding a glyeine/tyrosine- rich keratin-associated protein of hair 显示文摘 | Fratini A Powell B C Rogers G E | 1993 | J Biol Chem1993，268，6： | 1 |
| 12 | Material flow in FSW of T-joints: experimental and numerical analysis 显示文摘 | BUFFA G FRATINI L MICARI F | 2008 | International Journal of Material Forming2008，1，1： | 1 |
| 13 | Friction stir welding of lap joints: Influence of process parameters on the metallurgical and mechanical properties 显示文摘 | BUFFA G CAMPANILE G FRATINI L | 2009 | Materials Science and Engineering (A)2009，519，12： | 1 |
| 14 | Viral infections acquired indoors through airborne, droplet or contact transmission显示文摘 | La Rosa G Fratini M Della Libera S | 2013 | Ann Ist Super Sanita2013，49，2： | 1 |
| 15 | Solid state bonding in extrusion and FSW:Process mechanics and analogies 显示文摘 | Buffa G Donatib L Fratini L | 2006 | Journal of Materials Processing Technology2006，177，： | 1 |
| 16 | Influence of material characteristics on plastic mechanics of the FSW process for T-joints 显示文摘 | FRATINI L BUFFA G SHIVPURI R | 2009 | Materials & Design2009，30，7： | 1 |
| 17 | On the thermo-mechanical load and the resultant residual stresses in friction stir processing operations 显示文摘 | Buffa G Fratini L Pasta S Shivpuri R | 2008 | CIRP Annals-Manufacturing Technology2008，，57： | 1 |
| 18 | On the FSW of AA2024-T4 and AA7075-T6 T-joints: An industrial case study 显示文摘 | FRATINI L ACERRA F BUFFA G | 2010 | International Journal of Advanced Manufacturing Technology2010，48，9101112： | 1 |
| 19 | On microstructural phenomena occurring in friction stir welding of aluminium al- loys 显示文摘 | Barcellona A Buffa G Fratini L | 2006 | Journ#l of Material Process Technology2006，177，： | 1 |
| 20 | On the material flow in FSW of T-joints: Influence of geometrical and technological parameters 显示文摘 | FRATINI L BUFFA G MICARI F | 2009 | International Journal of Advanced Manufacturing Technology2009，44，56： | 1 |
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