[Technique of pancreatogastrostomy after pancreaticoduodenectomy]

A broad spectrum of different techniques for anastomosing the pancreatic remnant after the Kausch-Whipple procedure has been published. Most commonly used is the pancreaticojejunostomy, preferably in an end-to-side and duct-to-mucosa fashion. Utilisation of the posterior gastric wall represents an interesting alternative, which is being increasingly discussed in the literature. Two current meta-analyses and three prospective, randomised trials have proved the comparability of the two procedures. Accordingly, our own data show corresponding results regarding mortality and morbidity using this anastomosis. We personally prefer a purse-string suture for fixation of the pancreatic remnant, which seems to be more easily and more rapidly performed than application of interrupted sutures.