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ORIGINAL ARTICLE
Year : 2019  |  Volume : 38  |  Issue : 3  |  Page : 485-490

Safety and efficacy of isolated pancreatic anastomosis after pancreaticoduodenectomy


Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt

Correspondence Address:
MD Mohamad M Al-Hashash
Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejs.ejs_46_19

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Background Pancreatic leak after Whipple’s pancreaticoduodenectomy is the most serious complication being responsible for most of morbidity and mortality. Different techniques of reconstruction were developed to reduce the incidence of this complication. This study aims to evaluate the technique of isolated loop pancreaticojejunostomy after pancreaticoduodenectomy regarding its safety and efficacy. Patients and methods Morbidity and hospital mortality were evaluated in 25 patients underwent Whipple’s pancreaticoduodenectomy for malignant tumors followed by isolated loop pancreaticojejunostomy. Results Postoperative complications, occurred in nine (36%) patients, three patients developed anastomotic leak, two (8%) pancreatic and one (4%) biliary, the two pancreatic leaks were of grade A. Delayed gastric emptying developed in one (4%) patient. One (4%) patient died due to pulmonary embolism. The mean operative time was 383.4±38.3 min, the mean time of anastomosis was 136.6±20.03 min, the mean intraoperative blood loss was 525.2±225.8 ml and the mean hospital stay was 12.76±3.6 days. Conclusion Although isolated loop pancreaticojejunostomy associated with somewhat long operative time due to additional anastomosis, it is associated with low rate and grade of pancreatic fistula and contribute to reducing its severity and subsequent sequelae.


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