Low-pressure continuous suction of bile and pancreatic juice from the hepatic duct and jejunal limb after major hepatectomy with pancreatoduodenectomy.
We describe an effective technique for the low-pressure continuous suction of bile and pancreatic juice from the hepatic duct and jejunal limb after major hepatectomy with pancreatoduodenectomy (PD). After hepatectomy and PD, reconstruction is performed by a modification of Child's method. A pancreaticojejunostomy is completed with interrupted sutures between the pancreatic duct and mucosa, without inserting a stent. During hepaticojejunostomy, a 10-F silicone drain with side channels (Blake Silicone Drain; Ethicon, Somerville, NJ, USA) is placed within the hepatic duct via the stump of the jejunal limb to drain bile and pancreatic juice. The drain is connected to a continuous suction device and low suction pressure is started. We found that the low-pressure continuous suction of bile and pancreatic juice from the hepatic duct and jejunal limb was very effective after major hepatectomy with PD.
Yoshida
Hiroshi
H
Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
Mamada
Yasuhiro
Y
Taniai
Nobuhiko
N
Mizuguchi
Yoshiaki
Y
Nanbu
Kohtaroh
K
Mizutani
Satoshi
S
Satoh
Seiichi
S
Shioya
Takeshi
T
Tokunaga
Akira
A
Tajiri
Takashi
T
D000328:Adult; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D010179:Pancreas / Q000601:surgery; D010189:Pancreatic Juice; D016577:Pancreaticoduodenectomy; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D011312:Pressure; D019651:Plastic Surgery Procedures; D015607:Stents; D013396:Suction / Q000379:methods*