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Fish-Mouth Closure of the Pancreatic Stump and Parachuting of the Pancreatic End with Double U Trans-Pancreatic Sutures for Pancreatico-Jejunostomy

Authors
 Woo-Jung Lee 
Citation
 Yonsei Medical Journal, Vol.59(7) : 872-878, 2018 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2018
MeSH
Aged ; Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods* ; Aviation ; Female ; Humans ; Male ; Middle Aged ; Morbidity ; Mouth ; Pancreatic Fistula ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/surgery* ; Pancreaticoduodenectomy/adverse effects* ; Pancreaticojejunostomy/methods* ; Postoperative Complications/surgery ; Pylorus ; Sutures ; Treatment Outcome
Keywords
Blumgart anastomosis ; Pancreatico-jejunostomy ; Whipple's operation ; fish-mouth closure of pancreatic stump ; post-operative pancreatic fistula (POPF)
Abstract
PURPOSE: Leakage of pancreatico-jejunal anastomosis (PJ) remains the primary cause of morbidity and mortality after Whipple's operation. To reduce the occurrence thereof, the present author recently began to apply a modification of the Blumgart method of anastomosis after Whipple's operation (hereinafter referred to as Lee's method), with very good results. MATERIALS AND METHODS: The modified method and technique utilizes fish-mouth closure of a beveled pancreatic stump and parachuting of the pancreatic end with double U trans-pancreatic sutures (symmetric horizontal mattress-type sutures between the full thickness of the pancreas and the jejunal limb) after duct-to-mucosa pancreatico-jejunostomy. RESULTS: Eleven cases of pylorus preserving Whipple's operation have been performed without a clinically significant postoperative pancreatic fistula. CONCLUSION: This new method (Lee's method) may dramatically reduce the occurrence of postoperative pancreatic fistula after Whipple's operation.
Files in This Item:
T201802599.pdf Download
DOI
10.3349/ymj.2018.59.7.872
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
이우정(Lee, Woo Jung) ORCID logo https://orcid.org/0000-0001-9273-261X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163439
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