A novel technique for the management of pancreaticojejunal anastomosis dehiscence following pancreaticoduodenectomy

Abstract

Background: To report a novel technique for management of pancreaticojejunal anastomosis dehiscence after pancreaticoduodenectomy.

Material and methods: The anastomosis is disconnected and the blind jejunal limb is shortened and closed. A silicon tube in the pancreatic duct introduced in the first operation is fixed at the pancreatic stump. If no tube was placed during pancreaticoduodenectomy, it is placed at reoperation. The transected edge of the pancreas is stitched, and the distal part of the silicon tube is inserted into the jejunal loop and fixed in the jejunal wall. Drains and a catheter for continuous irrigation are placed.

Results: All patients tolerated reoperation and experienced unremarkable postoperative courses. Follow-up ranged from 5 to 27 months, and all patients exhibited normal pancreatic function and no pseudocyst formation.

Conclusion: This technique is an effective method for management of pancreaticojejunal anastomosis dehiscence that avoids complications associated with completion pancreatectomy and preserves pancreatic function.