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How to do a safe pancreatic anastomosis
Kaspar Z'graggen1, Waldemar Uhl, Helmut Friess
1Department of Visceral and Transplantation Surgery, University of Bern, Bern, Switzerland.
Journal of Hepato-Biliary-Pancreatic Surgery
|March 27, 2003
Summary
A two-layer pancreaticojejunostomy technique is a safe and reliable method for pancreatic anastomosis after pancreatic head resection, significantly reducing pancreatic fistula rates. This approach minimizes morbidity and mortality, enhancing patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Pancreaticojejunostomy leakage is a significant cause of morbidity and mortality following pancreatic head resection.
- Various techniques exist to secure pancreatic anastomosis to the pancreatic remnant.
Purpose of the Study:
- To evaluate the safety and efficacy of a specific pancreaticojejunostomy technique.
- To reduce the incidence of pancreatic fistula and associated complications.
Main Methods:
- An end-to-side pancreaticojejunostomy was performed.
- A two-layer, single-stitch technique using absorbable monofilament sutures was employed.
- Duct-to-mucosa adaptation was prioritized; catheter or stent drainage was not utilized.
Main Results:
- The study included 331 patients undergoing pancreaticojejunostomy.
- The described technique resulted in a low pancreatic fistula rate of 2%.
- The method proved reliable in experienced hands.
Conclusions:
- The employed pancreaticojejunostomy technique is safe and does not significantly contribute to post-resection morbidity and mortality.
- Further reduction in pancreatic fistulae and intraabdominal abscesses is anticipated.
- Non-pancreatic complications may become more critical determinants of patient outcomes.