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Updated: Mar 25, 2026

Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Double loop reconstruction following pancreaticoduodenectomy for malignant tumor: Short-term outcome
Paolo Limongelli1, A D'Alessandro1, S Parisi1
1XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
Background:
To evaluate the use of a double loop reconstruction following pylorus preserving proximal pancreaticoduodenectomy (PPPPD).
Methods:
Morbidity and mortality were evaluated in 55 patients undergoing PPPPD for malignant tumors, followed by a double loop reconstruction.
Results:
The mean intra-operative blood loss was 908mL±531. In-hospital mortality was 5.4% (3/55 pts). The mean length of hospital stay was 17±5 days (range 12-45 days). Postoperative complications occurred in 25 patients (46.2%). Five patients developed an anastomotic leak, one biliary and four pancreatic (4/55; 7%). Delayed gastric emptying occurred in 8 patients (14.5%). Reoperation was required in two patients for hemorrhage.
Conclusions:
A double loop alimentary reconstruction following PPPPD led to a low incidence of DGE and pancreatic fistula. Although mortality rate was higher than that reported by referral centres, this technique has been performed in a not specialized unit attaining acceptable results.
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