BACKGROUND: End-to-end pancreaticojejunal anastomosis after Whipple's resection poses a difficult surgical challenge because the disparity in the relative sizes of the cut pancreas and the jejunum makes it difficult to ensure a water-tight seal. Leakage exposes patients to potentially serious postoperative complications and mortality. METHODS: We describe a new technique to provide accurate telescoping of the pancreas into the jejunum by dilating and inverting the jejunum over the friable pancreas. RESULTS: The method appears to prevent leakage of pancreatic fluid at the anastomotic site. It has been successfully performed in 5 cases. No patient showed any evidence of pancreatic leakage and all survived uneventfully. CONCLUSIONS: The method is easy to perform and appears to be reliable. We believe it serves to reduce morbidity and mortality from pancreatic leakage.
BACKGROUND: End-to-end pancreaticojejunal anastomosis after Whipple's resection poses a difficult surgical challenge because the disparity in the relative sizes of the cut pancreas and the jejunum makes it difficult to ensure a water-tight seal. Leakage exposes patients to potentially serious postoperative complications and mortality. METHODS: We describe a new technique to provide accurate telescoping of the pancreas into the jejunum by dilating and inverting the jejunum over the friable pancreas. RESULTS: The method appears to prevent leakage of pancreatic fluid at the anastomotic site. It has been successfully performed in 5 cases. No patient showed any evidence of pancreatic leakage and all survived uneventfully. CONCLUSIONS: The method is easy to perform and appears to be reliable. We believe it serves to reduce morbidity and mortality from pancreatic leakage.