Improved technique for pancreaticogastrostomy with implantation method after pancreaticoduodenectomy.

We performed improved pancreaticogastrostomy after pancreaticoduodenectomy in 60 consecutive patients between August, 1993 and July, 1997. Our improved pancreaticogastrostomy was made by implantation method with pancreatic duct stent. Two-layer fusion of anastomosis between full thickness or mucosa/submucosa of gastric wall and pancreatic parenchyma was completed via gastric lumen with gastrotomy in the anterior gastric wall. The morbidity and mortality rates were 3% and 0%, respectively. There was absolutely no pancreatic leakage, and no postoperative complications directly related to the pancreaticogastrostomy. The biggest advantage of this procedure was to be able to anastomose in a good field of vision via gastric lumen with gastrotomy in the anterior gastric wall. This improved pancreaticogastrostomy seemed to be technically very easy and a safe method.