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Updated: Apr 29, 2026

Colonial Wig Pancreaticojejunostomy
Published on: March 12, 2019
An unusual complication of PEG feeding after pancreatico-gastrostomy
Mary Phillips1, Katy Hosie, Edward J Griffiths
1Royal Surrey County Hospital, Guildford, UK. mary.phillips1@nhs.net.
Context:
We describe a late complication of the pancreatico-gastrostomy (PG) anastomosis following pancreatico-duodenectomy (PD).
Case Report:
A percutaneous endoscopic gastrostomy (PEG) feeding tube was inserted many months post-operatively. In this patient activated pancreatic enzymes eroded the gastrostomy tract, resulting in pain, recurrent infection and eventual removal of the gastrostomy tube.
Conclusions:
Where surgical insertion of a feeding jejunostomy is not viable or deemed too high risk after Whipple or PPPD, we recommend careful consideration of PEG tube insertion in patients with PG reconstruction. If a PEG is used the prophylactic use of Lanreotide is recommended.
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