Abstract
Mortality and morbidity following pancreaticoduodenectomy (PD) is attributed mainly to leakage of the pancreticoenteric anastomosis. Although many surgical techniques for pancreatic anastomosis have been reported, no gold-standard technique has been defined. Pancreaticogastrostomy (PG) with invagination method has been commonly used in our department. In some cases where the stomach is unusable for reconstruction, we have applied end-to-side pancreaticojejunostomy (PJ) using the basic concept of the PG with the invagination method, resulting in a good clinical course. After a case with second reconstruction by PJ for pancreatic leakage following PG showed good recovery, we have changed to using PJ after PD. We have experienced 12 cases of PJ with the end-to-side invagination method in the last 2 years, with none showing pancreatic leakage. This PJ technique is very simple with a low risk of leakage, and seems to offer a versatile reconstructive technique.
