Pancreaticojejunostomy without stent (with video)

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Surgery

Background:

• Pancreaticojejunostomy carries a high risk of anastomotic leakage in patients with a normal, soft pancreas due to abundant exocrine function.
• The conventional stented method is often employed to mitigate this risk.
• However, alternative techniques may reduce the need for stenting.

Purpose of the Study:

• To evaluate the efficacy and safety of a nonstented duct-to-mucosa anastomosis technique for pancreaticojejunostomy.
• To demonstrate that this method can maintain adequate anastomotic patency without a stent tube.

Main Methods:

• The study describes a nonstented pancreaticojejunostomy technique using precise dissection and fine sutures.
• The pancreas is sharply transected, bleeding points are controlled, and a two-layer anastomosis is created.
• The inner layer specifically connects the pancreatic duct to the jejunal wall.

Main Results:

• The nonstented method achieved good results in performing pancreaticojejunostomy.
• This technique focuses on maintaining anastomosis patency through careful suturing.
• The procedure was found to be safe and reliable.

Conclusions:

• Complete pancreaticojejunostomy via duct-to-mucosa anastomosis can be safely performed without a stent tube.
• The nonstented method is a viable and potentially foundational procedure for pancreaticojejunostomy.
• This approach offers a safe and reliable alternative to stented methods.