title: New reconstructive surgery of remnant pancreas in cases of cancer of Vater's papilla.
abstract: OBJECTIVE
  The radical surgical procedure for treatment of the carcinoma of papilla of Vater is the pancreatoduodenectomy. The mortality rate of the surgery highly decreased in the last decade, nevertheless there are complications related to the complication of anastomosis of the remnant pancreas.
  
  
  METHODS
  The authors introduce a new reconstructional procedure to decrease the complications. After the removal of the pancreatic head and body an end-to-side anastomosis was performed between the pancreatic duct and a Roux-en jejunal loop. The second anastomosis of the procedure was an end-to-side choledochojejunostomy, the third was an end-to-side duodenojejunostomy. The duodenojejunostomy is about 40 cm from the pancreatic anastomosis, keeping food far from the pancreas with the help of peristaltic waves. This method was applied in 6 patients.
  
  
  RESULTS
  It was found that the new reconstructional procedure had generally favorable results without complication.
  
  
  CONCLUSIONS
  This method of reconstruction allows for spontaneous closure and safe drainage of potential insufficient pancreaticojejunostomy. The recovered patients support future favorable usage of this new reconstructional surgical procedure.
authors.affiliation: 2nd Department of Surgery, University Medical School of Debrecen, Móricz Zs. Krt. 22, 4004 Debrecen, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Arkossy
authors.forename: Peter
authors.initials: P
authors.lastname: Tóth
authors.forename: Istvan
authors.initials: I
authors.lastname: Kovács
authors.forename: Peter
authors.initials: P
authors.lastname: Sápy
mesh_terms: D000328:Adult; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D016896:Treatment Outcome