Radiology, Vol 196, 251-255, Copyright © 1995 by Radiological Society of North America
Pancreaticogastrostomy and the Whipple procedure: radiographic appearance and complications
EP Tamm, B Jones, CJ Yeo, MM Maher and JL Cameron
Russell H. Morgan Department of Radiology and Radiologic Science, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
PURPOSE: To evaluate the radiographic appearance of a
pancreaticogastrostomy (PG) and its complications. MATERIALS AND METHODS:
Seventy-two patients underwent pancreaticoduodenectomy and PG or
pancreaticojejunostomy. Those who underwent PG and were evaluated
postoperatively with T-tube cholangiography and upper gastrointestinal
(UGI) series constitute the study group (n = 22; 10 men, 12 women; age
range, 33-88 years). RESULTS: Twenty-one of the patients had a gastric
filling defect radiographically detected. Four patients had clinically
apparent delayed gastric emptying and one patient had a clinically apparent
pancreatic fistula not detected radiographically. Two patients outside the
study group had complications: One had a pancreatic fistula seen only with
sinography, and one had a PG leak seen only with repeat UGI series and
computed tomography (CT). CONCLUSION: PG caused a gastric filling defect in
most patients. Suspected pancreatic fistulas are best confirmed with
sinography, and suspected PG leaks may require repeat evaluation and CT.
Clinical findings of delayed gastric emptying do not correlate with
findings of UGI.
