A novel reconstructive procedure after pancreaticoduodenectomy: J-pouch dunking pancreaticojejunostomy.
Leakage of the pancreaticojejunostomy remains a major complication after pancreaticoduodenectomy. Several methods have been advocated in order to reduce anastomotic fistula but none of them reached a significant difference in preventing the leakage. We developed a new technique called "J-pouch dunking pancreaticojejunostomy". A "J" pouch is made from the distal 20 to 30 cm of jejunum by using a GIA linear stapler. A transverse incision is made on the jejunal base. As a result, we have enough jejunal stoma to anastomose the pancreatic remnant. A soft pancreas and small pancreatic size are known to be risk factors in pancreatic anastomosis. This technique is designed to eliminate the several factors related to pancreatic anastomotic leakage.
Müftüoglu
M A
MA
Haydarpasa Numune Haydarpasa Teaching & Research Hospital, Uskudar, Istanbul, Turkey. tmuftuoglu@ttnet.net.tr
Saglam
Abdullah
A
D000714:Anastomosis, Surgical / Q000379:methods*; D039021:Colonic Pouches; D004322:Drainage / Q000379:methods; D006801:Humans; D007583:Jejunum / Q000601:surgery; D010183:Pancreatic Ducts / Q000601:surgery; D010185:Pancreatic Fistula / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010193:Pancreaticojejunostomy / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D015607:Stents; D013528:Surgical Staplers; D013536:Suture Techniques