Pancreaticojejunostomy with invagination of spatulated pancreatic stump into a jejunal pouch

American Journal of Surgery
Hari S AsopaJyoti Asopa

Abstract

Pancreaticoenteric anastomosis after pancreatic resection is of major concern as anastomotic leak continues to be common. There is no unanimity for the preferred technique and overall incidence of pancreatic leak is reported to be 2% to 14%. A new safe method of anastomosing pancreatic stump to a jejunal pouch is described. A 15-cm length of the jejunal end is detubularized and reconfigurated into a U-shaped patch. The pancreatic stump is mobilized for about 3 cm and the duct is spatulated posteriorly and anastomosed to a cut in convex margins of the patch. This is converted into a pouch invaginating the spatulated pancreaticojejunal anastomosis. Eleven cases of periampullary malignancy after pancreaticoduodenectomy have been operated on with no pancreatic leak. Even a bulky pancreas can be invaginated into the pouch. The resulting anastomosis is completely intraluminal. Spatulated mucosa to mucosa anastomosis should reduce the chances of late stenosis.

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Citations

Aug 19, 2007·Langenbeck's Archives of Surgery·Shailesh V ShrikhandeParul J Shukla
Oct 15, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Woo Seok KimDong Do You
Jul 3, 2013·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Yi-Ping ZhuXian-Fa Wang
Apr 25, 2009·Pancreas·Shailesh V ShrikhandeMoritz N Wente
Mar 12, 2008·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Stefano CrippaClaudio Bassi
Aug 19, 2007·American Journal of Surgery·Xianfa WangXiujun Cai
Jul 14, 2007·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Ting-Bo LiangShu-Sen Zheng
Jun 14, 2006·ANZ Journal of Surgery·Chang Moo KangByong Ro Kim
Dec 15, 2010·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·A M ChromikW Uhl

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