Short-term outcome of new end-to-side inserting pancreatico-jejunostomy without stiches on the pancreatic cut end.

BACKGROUND/AIMS: Post-operative leakage from pancreatic anastomosis remains an important cause of morbidity in pancreaticoduodenectomy. It also contributes to prolonged hospitalization and mortality. We have developed a new inserting end-to -side pancreatico-jejunostomy without stiches on the pancreatic cut end or pancreatic duct.

METHODOLOGY

In this novel anastomosis technique, the pancreatic stump is first sunk into jejunum deeply in an end-to-side manner and tightened with a purse string in the bowel serosa. The pancreatic stump could be inserted completely inserting into the jejunum, independent of the size of the pancreas and jejunum. We performed this new anastomosis to 21 patients prospectively in Kumamoto University Hospital from April to October in 2012.

RESULTS

Postoperative pancreatic fistula was not observed at all in the 21 patients. There was no hospital death, whereas 6 patients developed postoperative complications. Importantly, one patient developed hemorrhage from pancreatic cut end into the jejunum.

CONCLUSIONS

This new method would be expected to minimize leakage from pancreaticojejunostomy. Further studies should be planned in a randomized controlled trial compared with another traditional pancreatico-jejunostomy.