title: [Anastomosis or closure of the pancreatic stump after duodenopancreatectomy?].
abstract: From 1986 to June 1990, 10 pancreaticoduodenectomies were performed in our Department (VIII Patologia Chirurgica, Università "La Sapienza", Roma). The reconstructive sequence was based on the pancreaticojejunal anastomosis (2 end-to-end pancreaticojejunostomies after invagination, 3 end-to-side Wirsung jejunostomies) in 5 patients. The pancreatic stump was sutured using a 50mm linear stapler in the remaining 5 patients. There was a high incidence (75%) of fistulization after direct suture of the pancreatic stump, although related mortality was null. Among patients treated with pancreaticojejunal anastomosis, a fistula on the end-to-end pancreaticojejunostomy with exitus of the patient, was registered in 1 case. On principle, we believe a end-to-side Wirsung jejunostomy should be performed after pancreaticoduodenectomy. When a safe anastomosis of the pancreatic stump cannot be performed (because of the soft parenchyma, easily lacerable) the technique of the direct suture with stapler is advisable.
authors.affiliation: Istituto di III Clinica Chirugica, Università degli Studi La Sapienza, Roma.
authors.forename: M
authors.initials: M
authors.lastname: Marchesi
authors.forename: M
authors.initials: M
authors.lastname: Biffoni
authors.forename: F
authors.initials: F
authors.lastname: Tartaglia
authors.forename: R
authors.initials: R
authors.lastname: Nobili-Benedetti
authors.forename: M
authors.initials: M
authors.lastname: Orlando
authors.forename: A
authors.initials: A
authors.lastname: Lentini
authors.forename: F
authors.initials: F
authors.lastname: Stocco
authors.forename: F P
authors.initials: FP
authors.lastname: Campana
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D014670:Ampulla of Vater; D000714:Anastomosis, Surgical; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery
vernacular_title: Anastomosi o chiusura del moncone pancreatico dopo duodenocefalopancreatectomia?