Journal of Gastrointestinal Surgery

, Volume 18, Issue 4, pp 869–877 | Cite as

Pancreaticoduodenectomy After Bariatric Surgery: Challenges and Available Techniques for Reconstruction

  • Ioannis Hatzaras
  • Teviah E. Sachs
  • Matthew Weiss
  • Christopher L. Wolfgang
  • Timothy M. PawlikEmail author
Review Article



Obesity is an epidemic in the USA, with approximately 7 % of the population considered morbidly obese (BMI > 40 or >35 with significant comorbidities).


Weight loss surgery is recognized as a durable solution to both obesity and obesity-associated morbidities. With an increasing number of pancreatic lesions being discovered on cross-sectional imaging, the pancreatic surgeon is increasingly likely to encounter patients with prior bariatric surgery who are in need of pancreaticoduodenectomy. As such, surgeons need to be familiar with the various bariatric operations, as well as the manner in which to handle prior bariatric reconstructions at the time of pancreatic surgery. Literature on this topic, however, is scarce with only a handful of small case series.


We herein review the different operations performed for weight loss, as well as provide an overview of the available operative approaches for reconstruction after pancreaticoduodenectomy in postbariatric surgical patients.


Obesity Bariatric Whipple Reconstruction 





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Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Ioannis Hatzaras
    • 1
  • Teviah E. Sachs
    • 1
  • Matthew Weiss
    • 1
  • Christopher L. Wolfgang
    • 1
  • Timothy M. Pawlik
    • 2
    Email author
  1. 1.Department of SurgeryJohns Hopkins HospitalBaltimoreUSA
  2. 2.Department of SurgeryBaltimoreUSA

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