title: An alternative pancreatic anastomosis following pancreaticoduodenectomy.
abstract: Pancreatic head resection and reconstruction is technically challenging. Eight patients underwent pancreaticoduodenectomy for either ductal adenocarcinoma (n = 7) or neuroendocrine tumor (n = 1) in the head of the pancreas with a dilated pancreatic duct. The pancreatic stump could not be mobilized to form a standard pancreaticogastrostomy or a pancreaticojejunostomy following resection because of a complete fixation to the splenic vein (n = 2), common hepatic artery (n = 1), or mesentery (n = 3) or inadequate length of the pancreatic remnant (n = 2). After laying open the pancreatic duct along the pancreatic transection margin in the ventral aspect of the pancreas, a longitudinal ventral pancreaticojejunostomy was performed using polydioxanone 3/0 sutures. The average time taken to create this pancreatic anastomosis was less than 10 minutes. This longitudinal ventral pancreatic anastomosis is quick, easy to perform, and a safe alternative method for pancreatic reconstruction after pancreaticoduodenectomy.
authors.affiliation: HPB Surgical Unit, Department of Surgery and Cancer, Hammersmith Hospital, Imperial College, London, England.
authors.forename: Georgia
authors.initials: G
authors.lastname: Bitsakou
authors.forename: Adam E
authors.initials: AE
authors.lastname: Frampton
authors.forename: Madhava
authors.initials: M
authors.lastname: Pai
authors.forename: Long R
authors.initials: LR
authors.lastname: Jiao
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D006801:Humans; D010179:Pancreas / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*