Protection of pancreatic and biliary anastomosis after partial duodenopancreatectomy by external drainage

Abstract

The pancreaticojejunostomy after duodenopancreatectomy is the "Achilles' heel" of the procedure. Herein we describe a technique for percutaneous drainage of the efferent limb of the Roux-en-Y loop relieving tension from the anastomosis. Seventy-six Whipple procedures, using this technique, have been done. The operative mortality rate was 1.3 per cent and anastomosis leakage occurred in two instances. In addition, one patient had to be reoperated upon for biliary fistula. Our technique for external Roux-en-Y loop drainage after partial duodenopancreatectomy is safe and efficient and permits rapid diagnosis of anastomotic complications.