الفهرس 
Dissertation abstractOnly 14 pages are availabe for public view
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Abstract
Introduction : Pancreaticoduodenectomy (PD) is one of the most extreme challenges in gastrointestinal surgery, with mortality about 5% in high-volume centers, and even 50% of perioperative complications. The pancreatic stump anastomosis is assumed the most difficult phase of the surgery, critical for postoperative healing. Technical failure at this stage causes postoperative pancreatic fistula (POPF) which is an actually fatal complication. Pancreatic cancer is considered the fourth cause of death for neoplasm in industrialized countries. A radical pancreaticoduodenectomy is the only chance, but this technique has significant mortality and morbidity even in high volume centers. There are some factors for evaluating the prognosis such as size of the tumor, degree of differentiation, status of lymph nodes and the involvement of the resected margins. Nevertheless, POPF’s risk, the anastomosis between the pancreatic stump and the gastrointestinal tract is considered the most real and safe technique of securing the remaining pancreas as it preserves the exocrine and endocrine function of the gland and ensures the best quality of life after surgery. Aim of this study : The aim of the study is to follow up and evaluate early outcome and complications regarding pancreatico-jejunostomy (duct to mucosa) for pancreatic anastomosis for cases underwent pancreaticoduodenectomy for different benign and malignant diseases of the pancreatic head and the periampullary region performed at Gastrointestinal surgery center –Mansoura university between January 2017 and November 2020. Patients and methods : This is a retrospective study done at GISC between January 2017 and November 2020 that includes 44 patients who underwent pancreaticoduodenectomy for different benign and malignant diseases of the pancreatic head and the peri-ampullary region were qualified for the study. Written informed consent was obtained from every patient after explaining the proposed surgical procedure and possible complications. The institute`s ethical committee approved the study protocol. Inclusion criteria : patient with either benign or malignant diseases of the pancreatic head and the peri-ampullary region who underwent pancreaticojujunostomy “duct to mucosa”. Results :from this study, it could be concluded that : POPF rate was 16.9% (8/44) while 6% of these cases were suffered from biochemical leak which did not affect the course of patients at all, this rate was similar to POPF ’s rates in different several RCTs which is usually less than POPF rates in other different techniques. In terms of morbidity rates, all of the RCTs that were included in the reported study, the total postoperative morbidity rate was 48.7% (205/421), however in our research, the overall morbidity rate was 16 cases ( 36% ). The length of hospital stay was given in the reported RCTs was 15.6 days, however the mean hospital stay in our
research was 10 days.