Successful treatment for combined pancreatoduodenal injury by a second-stage pancreatojejunostomy following pancreatoduodenectomy.

A case of combined pancreatoduodenal injury requiring pancreatoduodenectomy is described. A two-stage approach was used, which included a pancreatoduodenectomy followed by a tube pancreatostomy for complete external drainage of pancreatic juice and subsequent second-stage pancreatojejunostomy. This approach, first advocated by Miyagawa et al., enabled us to handle the normal soft pancreas without any complications. It is suggested that the described second-stage pancreatojejunostomy can be considered as an alternative method of restoring pancreatoenteric continuity following pancreatoduodenectomy in emergency cases.