title: An easy and secure pancreaticogastrostomy after pancreaticoduodenectomy: transpancreatic suture with a buttress method through an anterior gastrotomy.
abstract: OBJECTIVE
  The aim of this report was to describe a new reconstructive technique of pancreaticogastrostomy and to also discuss this procedure's effectiveness for reducing the incidence of postoperative complications.
  
  
  METHODS
  We retrospectively analyzed early surgical outcomes in 21 consecutive patients who underwent this novel pancreaticogastrostomy after pancreaticoduodenectomy. Pancreaticogastrostomy was completed with 2 transpancreatic sutures with buttresses on both the upper and lower edges of the implanted pancreas through the retracted anterior gastrotomy.
  
  
  RESULTS
  Operative mortality was zero and morbidity was 23.8%. A significant pancreatic fistula occurred in 1 patient (4.7%; grade B).
  
  
  CONCLUSIONS
  This technique is very easy to perform, less traumatic to the pancreatic stump, can be performed through a mini-laparotomy due to good vision and straight sutures, and it is secure owing to anchoring of the invaginated pancreatic stump to the stomach's posterior wall with buttresses. The results of this pilot study indicate that the technique may provide a favorable outcome and could be an alternative method of pancreatoenteric anastomosis. However, to determine its superiority over the conventional procedures, this operative technique should be evaluated more comprehensively in a larger series.
authors.affiliation: Division of Hepatobiliary-Pancreas Surgery, Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Tae Ho
authors.initials: TH
authors.lastname: Hong
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Youn
authors.forename: Young Kyoung
authors.initials: YK
authors.lastname: You
authors.forename: Dong Goo
authors.initials: DG
authors.lastname: Kim