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World J Gastroenterol. Jul 21, 2013; 19(27): 4351-4355
Published online Jul 21, 2013. doi: 10.3748/wjg.v19.i27.4351
Published online Jul 21, 2013. doi: 10.3748/wjg.v19.i27.4351
A new pancreaticojejunostomy technique: A battle against postoperative pancreatic fistula
Stylianos Katsaragakis, Andreas Larentzakis, Sotirios-Georgios Panousopoulos, Konstantinos G Toutouzas, Dimitrios Theodorou, Spyridon Stergiopoulos, Georgios Androulakis, 1st Department of Propaedeutic Surgery, Athens Medical School, Hippocratio Athens General Hospital, University of Athens, 11527 Attiki, Greece
Author contributions: Katsaragakis S conceived the idea, revised the manuscript and performed the majority of the procedures; Larentzakis A, Panousopoulos SG and Toutouzas KG assisted in the majority of the performed procedures and made a substantial contribution to the design, data acquisition and interpretation, as well as to the manuscript drafting and writing; Theodorou D, Stergiolpoulos S and Androulakis G contributed to the data analysis and revision of the manuscript; all the authors gave their final approval of the version to be published.
Correspondence to: Andreas Larentzakis, MD, PhD, 1st Department of Propaedeutic Surgery, Athens Medical School, Hippocratio Athens General Hospital, University of Athens, No 11, 3rd September 1843 str., Egaleo, 11527 Athens, Greece. alarentz@med.uoa.gr
Telephone: +30-210-5909561 Fax: +30-210-5909561
Received: January 23, 2013
Revised: April 23, 2013
Accepted: May 8, 2013
Published online: July 21, 2013
Revised: April 23, 2013
Accepted: May 8, 2013
Published online: July 21, 2013
Core Tip
Core tip: Pancreaticojejunostomy represents one of the most challenging technical aspects of the Whipple procedure, mainly due to its failure, and to the resulting morbidity and mortality rates. Several technical variations have been proposed, in an effort to minimize postoperative pancreatic fistula rates. The technique we describe is an end-to-side, duct-to-mucosa two-layer pancreaticojejunostomy intended to promote enhanced healing process, through the creation of a seromuscular jejunal flap. This technique appears to be safe and reliable; however, these are preliminary results.