Total pancreatic duct drainage for leakproof pancreatojejunostomy.
BACKGROUND
We describe a new method to achieve a safe and leakproof pancreatojejunostomy based on the hypothesis that anastomotic leakage will not occur if no accumulation of pancreatic juice precipitates it.


METHODS
Forty-eight patients underwent end-to-side pancreatojejunostomy with a pancreatic duct tube designed with an expanded segment to prevent slippage, which drained externally via the gastrostomy. The tube was tied to the main pancreatic duct with absorbable suture, which ensured complete external drainage of pancreatic juice during the postoperative healing period. After the tie was absorbed, the tube was simply removed.


RESULTS
Minor leakage of the pancreatojejunostomy developed in only two of the 48 patients, and both healed spontaneously without surgical intervention. No morbidity or death was related to the pancreatojejunostomy.


CONCLUSIONS
This method is safe, because even if leakage does occur the intestinal fluid contains no pancreatic juice.
Hamanaka
Y
Y
Department of Surgery II, Yamaguchi University School of Medicine, Japan.
Suzuki
T
T
D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts; D010193:Pancreaticojejunostomy / Q000379:methods*