Pancreaticojejunostomy after Whipple's operation--in vivo evaluation of long-term patency: a preliminary report.
Evaluation of the patency of the pancreaticojejunostomy was conducted in four patients who had undergone Whipple's procedure. Three patients had a mucosa-to-mucosa anastomosis, and in one patient the pancreatic remnant had been invaginated into the jejunal loop. The longest interval between the operation and the present study was 9.7 years. After intravenous infusion of secretin (1 microgram/kg), the temporal changes in the pancreatic ductal caliber were measured by means of either ultrasonography (two patients) or computed tomography (two patients). The presence of adequate functional pancreatic tissue was assumed in all four patients on the basis of their clinical status and the normal ductal caliber before the secretin provocation. In two patients, the ductal system showed an initial dilatation following secretin administration and then gradually emptied. There were no changes of the Wirsung duct in the other two patients. These data suggest that the pancreaticojejunal anastomoses were patent in all four patients but had different degrees of stenosis. The present method allows a safe and noninvasive evaluation of the anastomosis in vivo. Since long-term patency of the pancreaticojejunostomy is feasible, it should be attempted whenever possible in patients undergoing Whipple's procedure.
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010183:Pancreatic Ducts / Q000502:physiology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis; D012633:Secretin; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D012633:Secretin