Ann Hepatobiliary Pancreat Surg.  2019 Feb;23(1):65-68. 10.14701/ahbps.2019.23.1.65.

A modified single jejunal loop reconstruction by performing proximal gastrojejunostomy after Whipple's pancreticoduodenectomy in a low-volume hospital

• Yücesoy A

• KMID: 2439048
• DOI: http://doi.org/10.14701/ahbps.2019.23.1.65

Abstract

BACKGROUNDS/AIMS
It is needed to ensure bowel and biliary tract continuity after pancreaticoduodenectomies. It is possible to find a variety of reconstruction methods in literature.
METHODS
We realized a modified reconstruction method by performing proximal gastrojejunostomy, on a jejunal loop after Whipple's pancreticoduodenectomy, with surgical succes in 7 patients with pancreatic head or periampullary carcinomas in a low-volume hospital 2009-2017.
RESULTS
A modified jejunal loop reconstruction method, was performed in 7 patients after Whipple's pancreaticoduodenectomy. We had no perioperative mortality. Pancreatic fistula treated with medical attempts was observed following post-operative pancreatitis in a patient. No marginal ulceration was observed. Delayed gastric emptying was not observed, except for post-operative acute pancreatitis and pancreatic fistula developing in a patient.
CONCLUSIONS
A modified reconstruction method by performing proximal gastrojejunostomy on a jejunal loop, can be considered as alternative reconstructive surgical procedure after pancreaticoduodenectomy.

Keyword

Pancreaticoduodenectomy; Delayed gastric emptying; Marginal ulceration

MeSH Terms

Biliary Tract
Gastric Bypass*
Gastric Emptying
Head
Hospitals, Low-Volume*
Humans
Methods
Mortality
Pancreatic Fistula
Pancreaticoduodenectomy
Pancreatitis
Peptic Ulcer
Reconstructive Surgical Procedures

Figure

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  Fig. 1 End-to-end pancreaticojejunostomy by partly invaginating the remaining pancreas into the jejunum.

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  Fig. 2 Proximal gastrojejunostomy approximately 15 cm from pancreaticojejunostomy.

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  Fig. 3 Illustration of the modified single jejunal loop reconstuction by performing proximal gastrojejunostomy after Whipple's pancreaticoduodenectomy.

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