Treatment for dehiscence of pancreaticojejunostomy after pancreaticoduodenectomy: is resection of the residual pancreas necessary?
OBJECTIVE
Partial or total disruption of pancreaticojejunostomy (PJ) is a rare but serious complication after pancreaticoduodenectomy (PD). The recommended option of treatment is completion pancreatectomy. However, the mortality remains high as most patients were too critical to withstand the procedure.


METHODS
12 consecutive patients with dehisced PJ after PD were treated by oversewing the pancreatic stump without resection of the residual pancreas.


RESULTS
Although a high morbidity rate (75%) occurred after our management, ten patients survived reoperation, without recurrent pancreatic fistula or the need for insulin injection.


CONCLUSIONS
A complete pancreatectomy is not necessary for a dehisced PJ, if acute pancreatitis is not found in the residual pancreas.
Wu
C C
CC
Department of Surgery, Taichung Veterans General Hospital, Taiwan.
Hwang
C R
CR
Yeh
D C
DC
Hwang
Y C
YC
Liu
T J
TJ
P'eng
F K
FK
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D012086:Reoperation; D013529:Surgical Wound Dehiscence / Q000601:surgery*