The comparison of clinical results between hand suturing and mechanical stapling for gastrojejunostomy and jejunojejunostomy after SSPPD.

Background: Mechanical stapling method is widely established alternative to conventional hand suturing.

Method: For gastrointestinal anastomoses. In this study, we compare the clinical results of mechanical stapling with those of hand suturing for gastrojejunostomy and jejunojejunostomy after Subtotal Stomach Preserving Pancreaticojejunostomy (SSPPD).

Methods: Between 2002 and 2007, 42 patients who underwent SSPPD with concise records on operative procedure and time required for gastrojejunostomy and jejunojejunostomy were enrolled. Out of 42 patients, the mechanical stapling for gastrojejunostomy and jejunojejunostomy after SSPPD was performed for 19 patients and hand suturing for those in SSPPD was done for 23 patients.

Results: All clinical characteristics were similar in both groups. There was no statistical difference between both groups in the rate of complications related to gastrojejunostomy and jejunojejunostomy. However, days of nasogastric intubation and days until liquid diet in the stapled group were significantly shorter than those in the hand sutured group. Time required for gastrojejunostomy and jejunojejunostomy was significantly shorter in the stapled group than in the hand sutured group.

Conclusions: This study suggested that stapled anastomoses might require a shorter time to perform and decreased time for nasogastric intubation and until liquid diet is introduced.