Transection of the pancreas and closing the pancreatic duct using linear stapler followed by dunking method pancreaticojejunostomy versus duct to the mucosa in Whipple operation | ||
| The Egyptian Journal of Surgery | ||
| Volume 43, Issue 4, October 2024, Pages 1191-1201 PDF (717.16 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/EJSUR.2024.279817.1035 | ||
| Authors | ||
| Michael R. Roshdya1; Asaad A.E.R. Abd El Aziz2; Doaa A. Saad* 3 | ||
| 1Department of General and Hepato-biliary Surgery, Faculty of Medicine, Minia University, Minia, Egypt | ||
| 2Department of General Surgery, Faculty of Medicine, Minia University, Minia, Egypt | ||
| 3Department of General Surgery, Faculty of Medicine, Minia University, Minia, Egypt. | ||
| Abstract | ||
| Background: The anastomosis between the pancreatic stump and the gastrointestinal tract remains the most effective and safe method of controlling the pancreatic stump as it preserves the exocrine functions of the gland. The results of the previous literature seem contradictory. Patients and Methods: This study was performed on 40 patients. Patients were divided into two groups. Group A was managed by a division of the pancreas with linear stapler then dunking pancreaticojejunostomy, while group B was managed by a duct to mucosa pancreaticjejunostomy. The primary outcome was the incidence of pancreatic fistula. Results: Regarding the incidence of pancreatic fistula, group A showed a zero rate of pancreatic fistula while group B had 30% pancreatic leak. The mortality rate reached 15% in group B. Conclusion: Invagination technique by dividing the pancreas using the linear stapler then invagination appears superior to duct to mucosa technique as regards the incidence of pancreatic fistula. | ||
| Keywords | ||
| Pancreatic fistula; pancreaticoduodenectomy; pancreaticojejunostomy | ||
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