G J Toogood1, T G Wilson, R T Padbury. 1. Department of Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Abstract
BACKGROUND: Different techniques of reconstruction following pancreaticoduodenectomy have been described. A new modification using an isolated Roux-en-Y loop is reported. METHODS: The isolated loop is taken up to bile duct rather than pancreas as previously described. RESULTS: Seventeen patients have undergone this procedure. Two pancreatic fistulae developed, both following postoperative abscess formation. There was no operative mortality. CONCLUSION: This reconstruction provides separation of biliary and pancreatic fluid but adds two further benefits: the wide jejunal lumen allows for an easier pancreaticojejunal anastomosis, particularly when operating on a soft pancreas, and separation of gastric and biliary anastomoses prevents the efflux of bile into stomach.
BACKGROUND: Different techniques of reconstruction following pancreaticoduodenectomy have been described. A new modification using an isolated Roux-en-Y loop is reported. METHODS: The isolated loop is taken up to bile duct rather than pancreas as previously described. RESULTS: Seventeen patients have undergone this procedure. Two pancreatic fistulae developed, both following postoperative abscess formation. There was no operative mortality. CONCLUSION: This reconstruction provides separation of biliary and pancreatic fluid but adds two further benefits: the wide jejunal lumen allows for an easier pancreaticojejunal anastomosis, particularly when operating on a soft pancreas, and separation of gastric and biliary anastomoses prevents the efflux of bile into stomach.