Background: Duct to mucosa Pancreatico-gastrostomy (DMPG) is a method for reconstruction of pancreatic mass following pancreaticoduodenectomy (PD). There are still controversies about the benefits of this surgical technique compared to the old ones. Objectives: This study aimed to evaluate the long-term outcomes of DMPG reconstruction following PD operation. Method: Through a prospective observational setting, 164 patients, undergoing PD surgery, with diagnosed pancreatic head or peri-ampullary cancer, were enrolled. A pylorus-preserving PD and DMPG were done for all patients to reconstruct the pancreatic mass. Patients were followed up to a mean of 21.06±14.12 months. Demographic data, risk factors, tumoral staging, and postoperative follow-up data were collected for the analytic study. Results: The mean survival of the patients was 21.06±14.23 months after surgery. DGE (delayed gastric emptying) (34.75%), pancreatic fistula (21.34%), bile duct fistula (7.31%), and hemorrhage (5.5%) were recorded as the most important complication in patients. Some post-operative complications were significantly observed in patients with diabetes mellitus (pancreatic fistula, increased amylase, and DGE), Smokers (bile duct fistula, hemorrhage, and increased Amylase), and the elders (bile duct fistula) (p-value <0.05). Conclusions: Although our results indicate that DMPG reconstruction is a safe technique, our findings did not confirm the priority of this method over the older techniques.
Introduction: Complication after inguinal hernia repair is one of the challenging problems after inguinal hernia repair. This study aimed to compare the complications of three common surgical methods in inguinal hernia repair, Bassini, Lichtenstein, and Preperitoneal methods (with anterior approach). Methods: In this prospective study, patients who underwent inguinal hernia repair surgery in Baqiyatallah Hospital from June 2019 to May 2020 were included. Patients were allocated in three groups: Bassini, Lichtenstein, and Preperitoneal (with anterior approach), based on surgeons' opinions. Postoperative pain, hematoma and seroma, wound infection, recurrence, and also we assed postoperative satisfaction after surgery. Results: The mean age of patients was 49.90 ± 16.44 years, and 92.5% of patients were male. Of the total patients, 6.8% had an infection and there was no significant difference in the distribution of infection in the groups (P=0.230). The mean of pain in all patients was 2.37 ± 1.10. There was no significant difference between the three groups in the mean of pain (P = 0.253). There was no significant difference in the distribution of recurrence in the groups (P=0.356). There was no significant difference in the distribution of testicular swelling in the groups (P=0.421). No postoperative hematoma and seroma were reported in the groups. The mean of satisfaction in all patients was 93.61±19.63. There was no significant difference between the three groups in the mean of satisfaction (P = 0.156). Conclusion: The results showed that infection, pain, and recurrence rate in the Preperitoneal group were lower than the other groups, although this difference was not significant. Also, testicular swelling, hematoma, and seroma as well as patients’ satisfaction were similar between groups.
