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Pancreaticogastrostomy: How I Do It

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Surgery for Pancreatic and Periampullary Cancer

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Abstract

Pancreaticogastrostomy (PG) was first described by Waugh and Clagett from Mayo Clinic in 1946 [1]. Flaunter et al. popularized the technique and published their series in 1985 [2, 3]. Numerous theoretical and technical advantages are attributed to PG to explain the apparent safety of this procedure [4] including (1) the inactivation of pancreatic enzymes due to the low pH of the gastric lumen and lack of enterokinase in the gastric mucosa; (2) the alkaline pancreatic secretions that may help protect the pancreaticogastric anastomosis against marginal ulceration; (3) the anatomical proximity of the posterior gastric wall to the pancreatic remnant that allows for a very secure anastomosis without tension; (4) the thick gastric wall with its excellent blood supply that holds sutures very well; and (5) postoperative gastric decompression that is easily performed and provides constant removal of pancreatic and gastric secretions, thereby allowing less tension on the pancreaticogastric anastomosis.

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Authors and Affiliations

  1. Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India

    R. Mahendran M.S., M.Ch. (Surg. Oncol.) & H. S. Shukla M.S., F.R.C.S., Ph.D.

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  1. R. Mahendran M.S., M.Ch. (Surg. Oncol.)
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  2. H. S. Shukla M.S., F.R.C.S., Ph.D.
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Editors and Affiliations

  1. Chief Hepato-Pancreato-Biliary and Gastrointestinal Division, Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P., India

    Mallika Tewari

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Mahendran, R., Shukla, H.S. (2018). Pancreaticogastrostomy: How I Do It. In: Tewari, M. (eds) Surgery for Pancreatic and Periampullary Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-7464-6_13

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  • DOI: https://doi.org/10.1007/978-981-10-7464-6_13

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  • Online ISBN: 978-981-10-7464-6

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