title: A modified technique of pancreaticojejunostomy after pancreatoduodenectomy: a preliminary experience.
abstract: Pancreatoduodenectomy currently represents the treatment of choice for resectable pancreatic and periampullary malignant tumours, symptomatic chronic pancreatitis, duodenal cystic dystrophy, large adenomas, diverticula and benign periampullary tumours. Pancreato-jejunostomy failure remains the main complication following pancreatoduodenectomy, even leading to death. To improve the safety of this anastomosis, a modified technique of pancreato-jejunal anastomosis with posterior double-layer suture and Wirsung duct evagination is proposed. We report our experience in eight consecutive patients (4 females, 4 males; average age 66, range 57-74) undergoing Traverso-Longmire pylorus-preserving pancreatoduodenectomy using Wirsung duct evagination and posterior double-layer suture technique. There was no mortality; the post-operative recovery was uneventful with no pancreatic anastomotic leakage. The mean post-operative stay was 15 days (range 12-19). This proposed procedure could be considered an additional opportunity in the performance of a pancreato-enteric anastomosis, yielding good results and preserving from post-operative pancreatic ductal obstruction.
authors: Unit of Endocrine, Digestive and Emergency Surgery Unit, Department of Biomedical Sciences and Human Oncology, University Medical School of Bari, Policlinico, P. zza G. Cesare, 70124, Bari, Italy. mario.testini@chirgen2.uniba.it
authors: Mario
authors: M
authors: Testini
authors: Giuseppe
authors: G
authors: Piccinni
authors: Luigi
authors: L
authors: Greco
authors: Germana
authors: G
authors: Lissidini
authors: Angela
authors: A
authors: Gurrado
authors: Riccardo
authors: R
authors: Memeo
authors: Ilaria Fabiola
authors: IF
authors: Franco
authors: Vincenzo
authors: V
authors: Memeo
mesh_terms: D000368:Aged; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000601:surgery; D013536:Suture Techniques