Fish-Mouth Closure of the Pancreatic Stump and Parachuting of the Pancreatic End with Double U Trans-Pancreatic Sutures for Pancreatico-Jejunostomy.
10.3349/ymj.2018.59.7.872
- Author:
Woo Jung LEE
1
Author Information
1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. wjlee@yuhs.ac
- Publication Type:Original Article
- Keywords:
Pancreatico-jejunostomy;
Blumgart anastomosis;
fish-mouth closure of pancreatic stump;
post-operative pancreatic fistula (POPF);
Whipple's operation
- MeSH:
Aviation*;
Methods;
Mortality;
Pancreas;
Pancreatic Fistula;
Pylorus;
Sutures*
- From:Yonsei Medical Journal
2018;59(7):872-878
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Leakage of pancreatico-jejunal anastomosis (PJ) remains the primary cause of morbidity and mortality after Whipple's operation. To reduce the occurrence thereof, the present author recently began to apply a modification of the Blumgart method of anastomosis after Whipple's operation (hereinafter referred to as Lee's method), with very good results. MATERIALS AND METHODS: The modified method and technique utilizes fish-mouth closure of a beveled pancreatic stump and parachuting of the pancreatic end with double U trans-pancreatic sutures (symmetric horizontal mattress-type sutures between the full thickness of the pancreas and the jejunal limb) after duct-to-mucosa pancreatico-jejunostomy. RESULTS: Eleven cases of pylorus preserving Whipple's operation have been performed without a clinically significant postoperative pancreatic fistula. CONCLUSION: This new method (Lee's method) may dramatically reduce the occurrence of postoperative pancreatic fistula after Whipple's operation.
