Pancreaticojejunostomy after pancreaticoduodenectomy: results of a new technique

Hepatogastroenterology. Mar-Apr 2009;56(90):285-9.

Abstract

Background/aims: Pancreaticoduodenectomy is the standard treatment for periampullary tumors. One of the major causes of morbidity after pancreaticoduodenectomy is the failure of the healing at the pancreaticoenteric anastomosis. The aim of this study is to summarize the results of a new technique which is designed to decrease the panreticoje-junostomy anastomotic leakage.

Methodology: The demographic characteristics, operation indications, types of the pancreaticoduodenectomy, duration of the postoperative hospitalization, morbidity and mortality of the consecutive patients whose pancreaticojejunostomy anastomosis after pancreaticoduodenectomy was performed by modified invagination method at Hacettepe University Medical School Department of General Surgery between February 2005 and December 2007 were evaluated prospectively.

Results: Thirtyone patients were included in the study. The operation indications were pancreas cancer for 17 patients, ampulla Vateri cancer for 8 patients, duodenum cancer for 3 patients, cancer of the distal choleduct for 2 patients and gall bladder cancer for 1 patient. Twenty complications had occurred in a total of 15 patients. There were no pancreaticojejunostomy anastomotic leakage and mortality in any of the patients.

Conclusions: An ideal pancreaticojejunostomy anastomosis after pancreaticoduodenectomy should be safe, simple and secure. This modified invagination method seems to be promising when these parameters are taken in to account.

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical
  • Duodenal Neoplasms / surgery
  • Female
  • Gallbladder Neoplasms / surgery
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy*
  • Pancreaticojejunostomy / methods*
  • Treatment Outcome