Safer intestinal invagination for a solid pancreatico-jejunal anastomosis in presence of a soft texture pancreatic remnant and non-dilated duct

Hepatobiliary Pancreat Dis Int. 2016 Jun;15(3):324-8. doi: 10.1016/s1499-3872(15)60027-3.

Abstract

Pancreatico-jejunal anastomosis after pancreatoduodenectomy still represents the Achilles' heel of the procedure: the failure of this anastomosis is relatively common and it is the main cause of post-operative morbidity and mortality. Studies have described different reconstruction strategies for the control of the development of post-operative pancreatic fistula, but the strategy to obtain a safer pancreatico-jejunal anastomosis is still far from satisfaction. We report a novel variation of the invagination technique based on preliminary clinical experience in 8 patients who underwent pancreatico-jejunal anastomosis after pancreatoduodenectomy in our hepatobiliopancreatic center from 2008 to 2014. The variation could obtain a safer intestinal invagination for a solid pancreatico-jejunal anastomosis even in the presence of soft pancreatic remnant.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Aged
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Common Bile Duct Neoplasms / pathology
  • Common Bile Duct Neoplasms / surgery*
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy* / adverse effects
  • Pancreaticojejunostomy / adverse effects
  • Pancreaticojejunostomy / methods*
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Reoperation
  • Suture Techniques
  • Treatment Outcome