Double duct-to-mucosa pancreaticojejunostomy for bifid pancreatic duct.
We report a pancreaticojejunostomy with double duct-to-mucosa anastomotic technique after pyloruspreserving pancreaticoduodenectomy for chronic pancreatitis with bifid pancreatic duct. A 49-year-old Japanese man was diagnosed preoperatively as having chronic pancreatitis with common bile duct stricture and pseudocyst of the pancreatic head. In a pancreaticoduodenectomy, the main pancreatic duct (7mm in diameter) and a secondary pancreatic duct (4mm in diameter) were identified intraoperatively at the transected surface. Pancreatography showed the main pancreatic duct as well as thesecondary pancreatic duct that drained the remaining dorsal pancreas, allowing us to diagnose bifid pancreatic duct. The pancreaticojejunostomy was performed in an end-to-side manner to create double duct-to-mucosa anastomoses and to approximate the pancreatic parenchyma and jejunal seromuscular layers. Although bifid pancreatic duct is a rare anatomical anomaly, it behooves every surgeon who performs pancreatic resections to be aware of this entity and the techniques for dealing with it.
Yoshida
Takanori
T
Department of General Surgery, Nakatsu Municipal Hospital Nakatsu, Japan. yoshida-t@nakatsu-hosp.jp
Ninomiya
Shigeo
S
Morii
Yuji
Y
Matsumata
Takashi
T
Arimura
Eiichiro
E
Hidaka
Hiromu
H
D000714:Anastomosis, Surgical; D004322:Drainage; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery*; D010193:Pancreaticojejunostomy / Q000379:methods*; D011184:Postoperative Period; D011859:Radiography