Safer intestinal invagination for a solid pancreatico-jejunal anastomosis in presence of a soft texture pancreatic remnant and non-dilated duct.
Pancreatico-jejunal anastomosis after pancreatoduodenectomy still represents the Achilles' heel of the procedure: the failure of this anastomosis is relatively common and it is the main cause of post-operative morbidity and mortality. Studies have described different reconstruction strategies for the control of the development of post-operative pancreatic fistula, but the strategy to obtain a safer pancreatico-jejunal anastomosis is still far from satisfaction. We report a novel variation of the invagination technique based on preliminary clinical experience in 8 patients who underwent pancreatico-jejunal anastomosis after pancreatoduodenectomy in our hepatobiliopancreatic center from 2008 to 2014. The variation could obtain a safer intestinal invagination for a solid pancreatico-jejunal anastomosis even in the presence of soft pancreatic remnant.
Unit of Surgery, Department of Surgery and Translational Medicine, University of Florence Medical School, Careggi University Hospital, Florence, Italy. g.batignani@unifi.it.
Francesco
F
Giudici
Benedetta
B
Pesi
Daniela
D
Zambonin
Stefano
S
Scaringi
Paolo
P
Bechi
Giacomo
G
Batignani
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D013536:Suture Techniques; D016896:Treatment Outcome