Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 9, Issue 6, pp 733–737

How to do a safe pancreatic anastomosis

Authors

  • Kaspar Z'graggen
    • Department of Visceral and Transplantation Surgery, University of Bern, Bern, Switzerland
  • Waldemar Uhl
    • Department of Visceral and Transplantation Surgery, University of Bern, Bern, Switzerland
  • Helmut Friess
    • Department of Visceral and Transplantation Surgery, University of Bern, Bern, Switzerland
  • Markus W. Büchler
    • Department of Visceral and Transplantation Surgery, University of Bern, Bern, Switzerland

DOI: 10.1007/s005340200101

Cite this article as:
Z'graggen, K., Uhl, W., Friess, H. et al. J Hep Bil Pancr Surg (2002) 9: 733. doi:10.1007/s005340200101

Abstract.

Background/Purpose: Leakage of pancreaticojejunostomies has been associated with morbidity and mortality after pancreatic head resection. Different techniques have been described to perform a safe anastomosis to the left pancreatic remnant.

Methods: The pancreaticojejunostomy is preferably performed as an end-to-side anastomosis; drainage of the pancreatic duct by catheters or stents is not performed at our institution.

Results: Experience in more than 331 patients who underwent pancreaticojejunostomy indicates that a two-layer, single-stitch technique, with absorbable monofilament sutures and duct-to-mucosa adaptation, is a reliable method, with a pancreatic fistula rate of 2%.

Conclusions: The results obtained with the described technique of pancreaticojejunostomy indicate that the pancreatic anastomosis is very safe when performed by experienced hands and does not necessarily contribute to morbidity and mortality after pancreatic head resection. The prevalence of pancreatic fistulae and intraabdominal abscesses may further decrease, and the prevalence of nonpancreatic complications may have a more important impact on the outcome in the future.

Key words PancreaticojejunostomyPancreatic head resectionPancreatic fistulaPancreatic anastomosis
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© Springer-Verlag Tokyo 2002