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A modification of isolated Roux loop reconstruction after pancreaticoduodenectomy
G J Toogood1, T G Wilson, R T Padbury
1Department of Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Background:
Different techniques of reconstruction following pancreaticoduodenectomy have been described. A new modification using an isolated Roux-en-Y loop is reported.
Methods:
The isolated loop is taken up to bile duct rather than pancreas as previously described.
Results:
Seventeen patients have undergone this procedure. Two pancreatic fistulae developed, both following postoperative abscess formation. There was no operative mortality.
Conclusion:
This reconstruction provides separation of biliary and pancreatic fluid but adds two further benefits: the wide jejunal lumen allows for an easier pancreaticojejunal anastomosis, particularly when operating on a soft pancreas, and separation of gastric and biliary anastomoses prevents the efflux of bile into stomach.