title: A simple and safe anastomosis in pancreaticogastrostomy using mattress sutures.
abstract: When a suture does not trap a sufficient volume of pancreatic parenchyma in the conventional pancreatic anastomosis, laceration may be caused by even modest tension. Therefore, we used mattress sutures with gastric wall, which works protectively. An opening was made on the posterior wall of the stomach. By using a 3-0 polypropylene monofilament thread with a straightened needle at each end, the proximal gastric wall, the pancreas, and the distal gastric wall were sutured sequentially to accomplish anastomosis in a U-like fashion. After 2 to 4 additional sutures were completed, the pancreatic stump was invaginated into the stomach and all sutures are tied. Mattress sutures were made on the pancreas, which was held between the superior and inferior walls of the stomach. Postoperative amylase levels in the drainage fluid decreased significantly and none of the 17 patients developed pancreatic fistula formation. The technique is simple and shortens the time required for anastomosis.
authors.affiliation: Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. oohigasi-hi@mc.pref.osaka.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohigashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Yo
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Terumasa
authors.initials: T
authors.lastname: Yamada
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kishi
authors.forename: Shingo
authors.initials: S
authors.lastname: Noura
authors.forename: Ko
authors.initials: K
authors.lastname: Takachi
authors.forename: Isao
authors.initials: I
authors.lastname: Miyashiro
authors.forename: Masayuki
authors.initials: M
authors.lastname: Oue
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Shingi
authors.initials: S
authors.lastname: Imaoka
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D006801:Humans; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000601:surgery; D010185:Pancreatic Fistula / Q000517:prevention & control; D016577:Pancreaticoduodenectomy; D013270:Stomach / Q000601:surgery*; D013536:Suture Techniques