Modified Dunking Pancreaticojejunostomy.
- Author:
Hee Chul YU
1
;
Baik Hwan CHO
Author Information
1. Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea. hcyu@chonbuk.ac.kr
- Publication Type:Review
- Keywords:
Pancreaticoduodenectomy;
Pancreaticojejunostomy;
Pancreas
- MeSH:
Drainage;
Humans;
Mortality;
Pancreas;
Pancreaticoduodenectomy;
Pancreaticojejunostomy*;
Stents
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2007;11(1):27-31
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pancreaticojejunostomy (PJ-stomy) is one of the most common types of reconstructive surgical techniques utilized after a pnacreaticoduodenectomy (PD), but there are several ways to perform this procedure. The leakage of the PJ-stomy is recognized as an important complication that may lead to mortality. Recently, the use of a dunking PJ-stomy has been advocated in a modified fashion after PD. We have successfully used a one-layer interrupted snuggly end-toend PJ-stomy (modified dunking PJ-stomy) with a temporary transjejunal pancreatic stent technique for 30 consecutive PDs between January 2003 and December 2005. All of the patients received the modified dunking PJ-stomy, regardless of the characteristics of the pancreas stump (soft or hard, dilated or nondilated pancreatic duct). Four patients presented with post operative complications (morbidity, 13.3%). Only two patients (6.7%) developed a PJ-stomy dehiscence that healed with adequate drainage treatment. We observed a reduction in dehiscence of pancreaticojejunal anastomosis with the use of the modified dunking PJ-stomy, and no postoperative mortality. In conclusion, we have developed a simple, snug anastomosis method and most importantly it has proved to be safe regardless of the characteristics of the pancreas stump.