Inkwell pancreaticojejunal anastomosis after pancreaticoduodenectomy.
BACKGROUND
End-to-end pancreaticojejunal anastomosis after Whipple's resection poses a difficult surgical challenge because the disparity in the relative sizes of the cut pancreas and the jejunum makes it difficult to ensure a water-tight seal. Leakage exposes patients to potentially serious postoperative complications and mortality.


METHODS
We describe a new technique to provide accurate telescoping of the pancreas into the jejunum by dilating and inverting the jejunum over the friable pancreas.


RESULTS
The method appears to prevent leakage of pancreatic fluid at the anastomotic site. It has been successfully performed in 5 cases. No patient showed any evidence of pancreatic leakage and all survived uneventfully.


CONCLUSIONS
The method is easy to perform and appears to be reliable. We believe it serves to reduce morbidity and mortality from pancreatic leakage.
Rao
Addagada C
AC
Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St., Brooklyn, NY 11237, USA. acrao@aol.com
Gabriel
Guny
G
Serrano
Johnny
J
Benedicto
Ramon
R
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010193:Pancreaticojejunostomy / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome