BACKGROUND/ PURPOSE: Leakage of pancreaticojejunostomies has been associated with morbidity and mortality after pancreatic head resection. Different techniques have been described to perform a safe anastomosis to the left pancreatic remnant. METHODS: The pancreaticojejunostomy is preferably performed as an end-to-side anastomosis; drainage of the pancreatic duct by catheters or stents is not performed at our institution. RESULTS: Experience in more than 331 patients who underwent pancreaticojejunostomy indicates that a two-layer, single-stitch technique, with absorbable monofilament sutures and duct-to-mucosa adaptation, is a reliable method, with a pancreatic fistula rate of 2%. CONCLUSIONS: The results obtained with the described technique of pancreaticojejunostomy indicate that the pancreatic anastomosis is very safe when performed by experienced hands and does not necessarily contribute to morbidity and mortality after pancreatic head resection. The prevalence of pancreatic fistulae and intraabdominal abscesses may further decrease, and the prevalence of nonpancreatic complications may have a more important impact on the outcome in the future.
BACKGROUND/ PURPOSE: Leakage of pancreaticojejunostomies has been associated with morbidity and mortality after pancreatic head resection. Different techniques have been described to perform a safe anastomosis to the left pancreatic remnant. METHODS: The pancreaticojejunostomy is preferably performed as an end-to-side anastomosis; drainage of the pancreatic duct by catheters or stents is not performed at our institution. RESULTS: Experience in more than 331 patients who underwent pancreaticojejunostomy indicates that a two-layer, single-stitch technique, with absorbable monofilament sutures and duct-to-mucosa adaptation, is a reliable method, with a pancreatic fistula rate of 2%. CONCLUSIONS: The results obtained with the described technique of pancreaticojejunostomy indicate that the pancreatic anastomosis is very safe when performed by experienced hands and does not necessarily contribute to morbidity and mortality after pancreatic head resection. The prevalence of pancreatic fistulae and intraabdominal abscesses may further decrease, and the prevalence of nonpancreatic complications may have a more important impact on the outcome in the future.
Authors: F Francesco di Mola; Francesca Tavano; R Rita Rago; Antonio De Bonis; M Rosa Valvano; Angelo Andriulli; Pierluigi di Sebastiano Journal: Langenbecks Arch Surg Date: 2014-03-29 Impact factor: 3.445
Authors: Yakup Kulu; Bruno M Schmied; Jens Werner; Pietro Muselli; Markus W Büchler; Jan Schmidt Journal: HPB (Oxford) Date: 2009-09 Impact factor: 3.647
Authors: Somaiah Aroori; Puneet Puneet; Simon R Bramhall; Paolo Muiesan; A David Mayer; Darius F Mirza; John C Buckels; John Isaac Journal: HPB (Oxford) Date: 2011-10 Impact factor: 3.647