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Binding pancreaticojejunostomy: 150 consecutive cases without leakage
Authors:Email author" target="_blank">Shu?You?PengEmail author  Yi?Ping?Mou  Yin?Bin?Liu  Ying?Su  Cheng?Hong?Peng  Xiu?Jun?Cai  Yu?Lian?Wu  Lin?Hua?Zhou
Institution:(1) Department of Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009 Hangzhou, China;(2) Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
Abstract:The objective of this study was to verify the safety of a new technique termed "binding pancreaticojejunostomy" in a prospective cohort study. Pancreaticojejunal anastomostic leakage is a major cause of morbidity and mortality after pancreaticoduodenectomy. To prevent the development of pancreatic fistulas, we designed a special technique that we termed binding pancreaticojejunostomy. Binding pancreaticojejunostomy entails binding 3 cm of the serosamuscular sheath of the jejunum to the intussuscepted pancreatic stump. From January 1996 to May 2001, a total of 150 consecutive patients were treated with this type of pancreaticojejunostomy, including typical pancreaticoduodenectomy in 120, hepatopancreaticoduodenectomy in 17, pylorus-preserving pancreaticoduodenectomy in 10, and duodenal-preserving resection of the head of the pancreas in three. None of the patients developed pancreatic fistulas. The overall morbidity was 31.3%. The following complications occurred: gastrointestinal bleeding in six, pulmonary infection in 12, wound infection in 20, delayed gastric emptying in three, incision dehiscence in four, and hepatic insufficiency in two. The mean postoperative hospital stay was 19.8 ± 5 days. Binding pancreaticojejunostomy is a safe, simple, and effective technique. Presented at the Fourth Americas Hepato-Pancreato-Biliary Congress, Miami, Florida, February 27-March 1, 2003.
Keywords:Pancreas  surgery  pancreatic leakage  pancreaticoduodenectomy  pancreaticojejunostomy  binding
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