[Pancreaticojejunal anastomosis: the "Achilles heel" of pancreaticoduodenectomy].

This article reviews available data on factors influencing healing of pancreatic anastomosis following pancreaticoduodenectomy. Technical approaches of various techniques of pancreatic anastomosis including pancreaticogastrostomy are discussed and compared. Attention is paid to the other associated risk factors for pancreatic anastomotic leakage such as patient status, as well as morphologic and physiologic peculiarities of pancreatic remnant. The concept of pharmacological prevention of anastomotic leakage is discussed.