title: Low-pressure continuous suction of bile and pancreatic juice from the hepatic duct and jejunal limb after major hepatectomy with pancreatoduodenectomy.
abstract: 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.
authors.affiliation: Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Kohtaroh
authors.initials: K
authors.lastname: Nanbu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mizutani
authors.forename: Seiichi
authors.initials: S
authors.lastname: Satoh
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shioya
authors.forename: Akira
authors.initials: A
authors.lastname: Tokunaga
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
mesh_terms: 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*