Management of the stump of the pancreas after distal pancreatic resection.

The optimal management of the stump of the pancreas following distal resection remains controversial. To determine whether there was an advantage in draining the stump of the pancreas into a Roux-en-Y loop of jejunum, a retrospective survey of 113 patients who had a distal pancreatectomy for chronic pancreatitis or complications of acute pancreatitis in the non-acute phase was undertaken. The decision to perform a drainage procedure was determined on the basis of the pancreatogram, the size of the pancreatic duct and technical factors at the time of the operation. Sixty-seven patients had no drainage procedure and 46 patients had a drainage procedure. The two groups were comparable in all respects before surgery. The postoperative outcome in the short- and long-term was similar in both groups. It is concluded that caudal pancreatic drainage confers no benefit following distal pancreatic resection.