[T-L mucosa to mucosa pancreatojejunal anastomosis for pancreatic reconstruction following a duodenopancreatectomy].
BACKGROUND
The pancreatojejunal anastomosis is considered the weak spot when carrying out a duodenopancreatectomy, because it causes most of the complications following a Whipple surgery. Here we present a series of cases using a single technique for performing this anastomosis.


METHODS
During the period between October 2002 and August 2005, 49 duodenopancreatectomies were performed at the 3AII Department of the National Hospital Edgardo Rebagliati Martins - H.N.E.R.M., in 31 of these cases a lateral mucosa to mucosa pancreatojejunal anastomosis was carried out by the same surgeon.


RESULTS
The most frequent complication was infection of the operating wound followed by pancreatic fistula and intra-abdominal hemorrhage and the overall morbidity was 29%. Pancreatic fistula developed in 13% of the cases; however, no patient required additional treatment and the fistula closed maximum twenty days after the surgery. On average, patients resumed oral food intake after 6 days and remained hospitalized for 16 days. Mortality was 3%, because a patient developed a pseudo-aneurism of the hepatic artery, which ruptured 17 days after the operation.


CONCLUSIONS
The mucosa to mucosa pancreatojejunal anastomosis is a safe technique with a low index of pancreatic fistula and mortality.
Targarona
J
J
Médico del servicio 3AII cirugía de hígado vías biliares y páncreas.
Garatea
R
R
Rosas
J
J
Romero
C
C
Rosamedina
J
J
Lora
A
A
Montoya
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy / Q000379:methods*