Surgery Today

, Volume 43, Issue 7, pp 821–824

End-to-side pancreaticojejunostomy without stitches in the pancreatic stump

  • Daisuke Hashimoto
  • Masahiko Hirota
  • Yasushi Yagi
  • Hideo Baba
How to Do It

Abstract

In patients undergoing pancreaticoduodenectomy, leakage from the pancreatic anastomosis remains an important cause of morbidity and contributes to prolonged hospitalization and mortality. Recently, a new end-to-end pancreaticojejunostomy technique without the use of any stitches through the pancreatic texture or pancreatic duct has been developed. In this novel anastomosis technique, the pancreatic stump is first sunk into deeply and tightened with a purse string in the bowel serosa. We modified this method in an end-to-side manner to complete the insertion of the pancreatic stump into the jejunum, independent of the size of the pancreas or the jejunum. We tested this new anastomosis technique in four pilot patients and compared their outcomes with four control patients who underwent traditional pancreaticojejunostomy. No severe pancreatic fistulas were observed in either group. There were no differences in morbidity or hospital stay between the groups. This new method can be performed safely and is expected to minimize leakage from pancreaticojejunostomies.

Keywords

Pancreaticoduodenectomy Pancreaticojejunostomy Pancreatic fistula 

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Copyright information

© Springer Japan 2012

Authors and Affiliations

  • Daisuke Hashimoto
    • 1
    • 2
  • Masahiko Hirota
    • 2
  • Yasushi Yagi
    • 2
  • Hideo Baba
    • 1
  1. 1.Department of Gastroenterological SurgeryKumamoto University Graduate School of Medical SciencesKumamotoJapan
  2. 2.Department of SurgeryKumamoto Regional Medical CenterKumamotoJapan

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