THREE CASES OF PANCREATICOGASTROINTESTINAL ANASTOMOSIS RECONSTRUCTION AFTER PANCREA TICODUODENECTOMY

Abstract

We recrently experienced three cases of pancreaticogastrointestinal anastomosis reconstruction after pancreaticoduodenectomy.
Case 1: A 48-year-old roan underwent PPPD-IV C for gastrinoma of the duodenum. After the operation, he had repeated pancreatitis. Therefore a resection of pancreatogastomy and reconstruction anastomosis of pancreatojejunostomy were performed.
The patency of the main pancreatic duct was confirmed at the second operation. We think that the cause of repeated pancreatitis might lie in the resected portion of the pancreas and anastomosed location at pancreatogastomy in the stomach.
Case 2: A 74-year-old woman underwent PPPD-II for a lower bile duct cancer. And then hemorrhage occurred due to the leakage of pancreatojejunostomy. The second operation was done, when a resection of the pancreatojejunostomy and reconstruction of pancreatogastomy were carried out.
Case 3: A 49-year-old man underwent PPPD-II for mucin producing tumor (MPD) of the pancreas before ten years. After the operation, gradually progressed stenosis of pancreatojejunostomy and recurrence of MPT around superior mesentri aretery (SMA) occurred. A resection of the tumor around SMA and reconstruction anastomosis in choledocojejunostomy and pancreatojejunostomy were performed.
Todays, either benign or malignant tumors at the pancreas are indicated pancreatoduodenostomy. We suggest that any acute and chronic complications of pancreatogastrointestinal anastomosis can be recovered by positive operation reconstructing anastomosis.