Pancreatojejunostomy by Duct-Insertion Method: Clinical and Experimental Study

Summary

We have applied the duct-insertion method with complete drainage of pancreatic juice to patients with normal pancreatic tissue and an undilated pancreatic duct, and the duct-mucosal suture method to patients with hard pancreatic tissue and a dilated pancreatic duct. The safety and certainty of this duct-insertion method was examined by experiments with animals. There was no significant difference in bursting pressure of the anastomosis and hydroxyproline content between the two methods. In the histopathological findings, adhesion of the subserosal layer was found at 14 postoperative days and regenerative mucosa at 28 days after operation. In a clinical study, there was no significant difference in frequency of leakage. The value of pancreatic functional diagnostant (PFD) was maintained at a high rate 12 months after operation. It was considered that anastomotic patency was preserved. It is concluded the duct-insertion method is a safe and useful procedure, especially for patients with normal pancreatic tissue and an undilated pancreatic duct.