Total pancreatic duct drainage for leakproof pancreatojejunostomy

Abstract

Background: We describe a new method to achieve a safe and leakproof pancreatojejunostomy based on the hypothesis that anastomotic leakage will not occur if no accumulation of pancreatic juice precipitates it.

Methods: Forty-eight patients underwent end-to-side pancreatojejunostomy with a pancreatic duct tube designed with an expanded segment to prevent slippage, which drained externally via the gastrostomy. The tube was tied to the main pancreatic duct with absorbable suture, which ensured complete external drainage of pancreatic juice during the postoperative healing period. After the tie was absorbed, the tube was simply removed.

Results: Minor leakage of the pancreatojejunostomy developed in only two of the 48 patients, and both healed spontaneously without surgical intervention. No morbidity or death was related to the pancreatojejunostomy.

Conclusions: This method is safe, because even if leakage does occur the intestinal fluid contains no pancreatic juice.